almost there

Sorry its been awhile since I posted, things have been rather hectic since I stopped work 2 weeks ago.Have had lots of Dr appointments and tests, some in preparation for surgery and some to follow up after chemo. The best thing however is my MRI results, which shows the previous enlarged lymph nodes are now gone and in the breast there are only 2 small 1/2 cm tumors left, which may even represent scar tissue and not cancer, we won't really know until they look under microscope at surgery time. Amazing since it was so large before.It shows I had a great response to chemo, so although it was tough it did what it was supposed to do.

Surgery is Wednesday and I'm not looking forward to it, I want the cancer gone and to be cured which I believe will happen,I just wish that I didn't have to loose my breasts in order to achieve it. One day they will come up with something different. Although this has been tough there are a lot worse things out there, and if you have to get cancer, breast is a better one to get because the cure rate is so much better than it used to be.It is however, still the leading cause of death in my age group due to the fact that at this age we are not plagued with other illnesses and are generally healthy. Hopefully everyone is up to date on their mammograms, early detection is the key.

So what else have I been doing apart from running to appointments, well had a lovely Thanksgiving and went to Coronado to see my Aunt and Uncle. My Aunt however gave us all a scare as she woke up with chest pain and we ended up in the ER at 1am, they however discharged her later in the day after doing cardiac enzymes and a treadmill and follow up instructions for further testing as an outpatient. She at least got to be home and enjoy Thanksgiving dinner.I have also been trying to get organized for Xmas and of coarse managed to buy lots of things for me and the house, not too many other gifts however, so now I'm stressed as I only really have a few days to do that and I have no idea what to get for people.

My Dad arrived yesterday, and will be here for 3 weeks so that will be nice,although I'm not sure that it is going to be too much fun for him as he's not able to drive here,(doesn't want to drive)so he can't get out and about. At least the weather is better here than in Scotland at the present, so he may just enjoy not freezing and getting wet.

Fiona hasn't managed to give me a heart attack yet with her driving, she's actually doing ok ,it's just scary being in the passenger seat while she learns and makes mistakes.Tomorrow she has a lesson on the freeway, so avoid the 405 at 5pm for those that live here.

Here are the 3 great questions /statements that were asked by others to me re illness, hopefully they'll make you laugh.

1. Asked by my cousins husband, so how do you think you caught this; my response, oh I don't know probably from the toilet seat.
2. By my mum, one of the smartest people I know, "well it's a virus", talking about cancer of coarse.
3.The cutest and said by my friends 5 year old, "Karen i think I know why you got sick, you ate too much Halloween candy". He may be right there.

Well it is after 1am and I can't sleep but better try.

DONE, FINISHED

Yes, I'm done. I can't believe this part is over and I am done,done,done,hopefully never to be repeated again. It really has been an ordeal and probably the hardest thing I've ever had to deal with. I've endured chemo a total of 11 times over 6 months and have had 4 different drugs during that time. The average treatments are usually between 4 and 6 times, so I've had double the average. The goal of doing chemo first was to kill the cancer hard and fast and hopefully that is exactly what has happened, we will know when the pathology results come back at surgery.

Meanwhile I have a few weeks to get stronger, relax,and get ready for part 2. I am really looking forward to my time off prior to surgery, time to catch up, get ready for xmas, not work, spend time with friends all between lots more Dr appointments, MRI,echocariogram and repeat mammogram.

Many times during these past 6 months i've managed to put a brave face on, but without fiona and some great friends it really would have been unbearable. Times like this are when you find out who your true friends are.I also work with some amazing people who have been very generous and supportive.

So on this happy note, I am going to enjoy my time off and revel in no more chemo.

Almost done

                                                                     MARTINI TIME 

Sorry, I know it's been a long time since  I wrote anything. Well since the last time we spoke I have received another treatment, had my usual week of feeling like crap and am presently in the phase of feeling well, although I still don't have my usual energy, my energy level that is before chemo started. I am looking forward to not feeling so tired all the time.

My last treatment is November 13th and I honestly am so looking forward to this being over. I absolutely HATE the treatments and each one feels harder than the last. I put a good face on and try to get on with things but sometimes I really want to curl up in a ball and will it all away,and it will be soon. Of course after all the chemo fun I have to have surgery, again another thing to look forward to, NOT. My date is Dec 10th and I have decided on a double mastectomy. The reason for the double is my left side already shows calcified areas that they wanted to recheck after the MRI, my chance of another cancer in that side is 20% and I just don't want to live in fear all the time of getting it again. Emotionally having surgery will be hard because breasts are part of being a woman and all the fun things that go along with it. Also there will never be any sensation there after they create new ones. 

I have been working pretty much full time recently but am still really wiped out in the evenings, I am however going to take some time off before my surgery to get a little stronger. I'll be off for about 3 months, by the time I'm ready to go back to work I'll not know what to do any more as it's been six months since I worked on the floor. I can't believe it's been that long already, but I was diagnosed end May and started treatments early June.

Well since I last wrote, I turned a year older and I guess I should celebrate that, although chemo I think has made me look years older. All birthdays will now be ones to celebrate and be grateful for. I had a wonderful surprise dinner celebration organized by friends at work, so that was really nice. They then surprised me with a huge card and said that they were collecting for a trip away somewhere. Amazing. I work with great people and I am blown away by their thoughtfulness. So I have something to look forward to when this is all over. 

Dawn Marie and I , the old cronies that we are, went to see Tina Turner a few weeks ago, she is still so energetic and looks great at 69 (tina turner that is). It was a fun concert. Fiona is still trying to drive, although I've not given her too much opportunity yet to practice. Emotionally she says she's doing ok and I have to take that at face value. She appears ok and has the usual 16 year old attitude. 

Well only 5 more days till last chemo :) 

Karen

Done

Can't sleep and decided I'd write a few lines.  Feel like crap, look like crap and wish this was all over.  There that says it all.

Will write more when in better spirits!

5th cycle

Yes, yes I know it has been a while since I wrote anything, same old excuses as I always give. I had my 5 th cycle almost 2 weeks ago, adriamycin and cytoxan which were new drugs to me. I was pretty nauseated for quite a few days, and really really fatigued, took all my effort just to get off the couch and shower. The fatigue lasted about a week but not as severe as it was initially. All in all I am feeling great and I now know I have one week of feeling like crap but 2 weeks of feeling well which feels so good. I think with the first 4 cycles I got used to just feeling well when I got hit again;at least this time I have extra time to recover. The only other side effects I am /have experienced is occasional numbness to my toes, change in nail color and texture to my nails, hot flashes and chemo brain, at least I can blame my forgetfulness on that anyway. There is now light at the end of the tunnell, I've had a total of 8 chemo treatments and only 3 more to go.

I am still working usually at least 50-72 hours a pay period( every 2 weeks), yes I miss looking after patients but it is also nice to work for a while in an area with no stress. At least at work I have something to occupy my mind, at home I'd be staring at the walls and feeling sorry for myself, so I am glad I am able to work at the moment.

I saw the plastic surgeon last week and he seemed nice but more importantly I saw pictures that helped me come to terms a little more as to what to expect. Surgery is scheduled for dec 10th 7.30am bright and early!

I am so grateful for all the support and help I have received, gardening, meals and transporting Fiona, to general concern and well wishes.

I became an Aunt today, my step sister had a little baby boy, unfortunately we won't be able to see him for a while as she lives in Scotland.

Fiona is still doing well, seems to be enjoying school, continues with cross country and started driving school last night and looking forward to actually driving.
I'll keep you all informed of any new developments.

4th cycle over

 I've been getting nagged at "hey you haven't written in your blog for a while." Yes, sorry, every night I say to myself I must write, but to be honest I feel that I'm

 repeating myself over and over again and that it sounds rather boring, also when at school I didn't pay attention in my typing class and only type about 1 word a minute. Okay enough of the excuses!

So, cycle 4 is now over and done with. The first treatment went ok with just the usual fatigue, some nausea and abdominal pain/ epigastric area. I was really dreading the 2nd part and every time I thought about it I felt sick, still do at times, it's like Pavlov's dog response. Anyway it was better than I expected with only the actual day of chemo being the worst, vomiting several times with horrible epigastric pain again, however the next few days were better with little N/V, and generally feeling not too bad. The white cells are staying high with the 2 different medications I take, neupogen and neulasta, the hemoglobin dropped again, but I have no doubt that it'll come back up by the time of my next cycle. I've been eating like a pig, (when I feel nauseated eating carbs seems to help, potatoes, bread, ice cream..etc) so I need to start watching as I don't want to gain too much weight.  I  also haven't done any exercise and am now totally sedentary at work and not walking the 2 miles at least that we do when working so that doesn't help much. I really would like to get enough energy back to go and run, exercise a little at least.

These next 4 cycles are now every 3 weeks, starting on the 11th. Drug names for those who are interested, are Adriamycin and cytoxan (lovely name ie. toxic), they've been around  for years in the treatment of breast and other cancers. One of the most common side effects are nausea/vomiting (N/V ) just what I love... not.  I think I can tolerate most things but I HATE N/V. They give pretty large doses of steroids to help with the side effects so hopefully it works. I'll let you know next time. Until then I am enjoying just feeling well. It's amazing how much we take feeling well and having energy for granted, how I would love to run another marathon right now!

Well Fiona is now back at school, 2 days in and she's already commenting on how she wishes it were summer again. It is going to be a difficult year with chemistry, geometry and her other subjects, so hopefully she's handle it, especially with her extra responsibilities at home when I am sick. She is also starting driving lessons at the end of the month, scary. I still think they need to change the driving age to 18 but that's an ER nurse talking. The whole idea of her in a car freaks me out, so I am not doing any of the teaching, at least for the moment anyway. She's off to her school dance tonight and looking to check out all the guys or hotties as she calls them, god am I old!

Ok bloggers that's enough for tonight. Hope you are all well, till next time. 

Cycle 3

I know it's been a while since I've written, sorry, sometimes I don't know what to say and I feel I'm just repeating myself over and over. Other times I'm just too tired, or just lazy.

I had my first part of cycle 3 on the 31st of July and the second part on the 7th. My WBC were really high prior to my first treatment, 15,000, this of cource was due to the neupogen and neulasta.  I did pretty well after the first part, more energy than usual, no diarrhea or nausea, just the usual mouth discomfort.

 The second part of course is always another story as your body doesn't get time to recover before it is assaulted again. I again gave myself 5 neupogen shots the day after my first treatment and my WBC's  remained pretty high at 7.3 prior to the second treatment. The bad news is my hemoglobin dropped to 9.6 from 11.5, so I am now anemic and need to try and correct it with diet or else another red cell booster similar to epogen.

 The night of my second treatment I had severe epigastric pain with nausea, seemed a little better on Friday and on Saturday I had nausea and vomiting and stayed in bed all day watching the Olympics, sleeping and trying to keep fluids down. When you feel lousy, at least for me, that is when I feel the loneliest and wish I had a partner to hold me and comfort me  and just make me feel better. I have great friends but they just can't take the place of a man in that respect. Maybe I'm living in dream land because let's face it most men don't know how to feel or what to do when someone is sick. I'm hoping I'll feel a little better over the next few days and then I'll be great again until the 21st, when I receive my 4th treatment. There is light at the end of the tunnel however, as my last part of this drug regimen and my half way mark will be 8/28. After that I will change to 2 different drugs and the 4 cycles will be every 3 weeks.

I saw a breast surgeon last week and she talked about the different surgical options(none of them being keeping my breast). I now need to make appointments with plastic surgeons for consult as there are different options available: implants or using fat and skin from abdomen to reconstruct. Like everything there are pro's and con's to both. I have lots of time however to decide what will be best for me.

I am still working 3 1/2 days a week and sometimes more. Last week after seeing the surgeon I decided to look at the plastic surgeon's web site and didn't like what I saw. Someone at work told me about a paramedic who'd had breast cancer and implants. I saw her at work and plucked up the courage and went over to her and asked if I could see her implants, real life is always better than pictures(I was teary eyed asking, it takes a lot of guts to ask a complete stranger to see their boobs) well you guessed, I asked the wrong medic, she said "I don't have implants". Did I feel stupid, and no doubt she'll go back to the station and tell all the guys, so they'll all have a good laugh as I did, but later in the day.

Fiona had her 16th birthday on Monday the 4th, she kept saying she didn't want to do anything special with her friends. We ended up going to an Italian restaurant with john and a few close friends, she had a good time and of course now feels older and wiser. Everyone asks "how's Fiona doing",  she obviously worries when she sees me not feeling good but on the whole she seems to be doing okay but really doesn't talk too much about how she feels. 

I'll try and post a few pictures of fiona's 16th and I'll let you see me bald, which I am now getting more used to.  Again thanks to everyone.

Karen

Had my second part of cycle two on Thursday. My WBC's this time were still low 2.3, and my ANC (absolute neutrophil count), which are a sub set of white cells, were 1.0. The ANC cut off per MD for receiving chemo is about 1.0, however I still was able to receive my treatment. I had given myself neupogen ( a WBC builder) for 4 days, so this next time they want me to take it for 5 days.Thank goodness for insurance, the cost of 8 neupogen shots $2,500, my cost $30, crazy eh, and if I got the pre filled syringes which insurance wont pay, the cost was $4,300.

This last treatment really kicked my butt. I was really tired and just wanted to sleep all the time, I think I slept about 16 hours a day, the couch being my favorite spot during the day. I had slight nausea, but horrible diarrhea with cramping and spasms. This lasted about 4 days and by Tuesday my energy level had improved and the diarrhea was much improved. I realized today when my oral mucous membranes start to return to normal color then my GI symptoms are better and when my mouth is white and sore then the GI system is the same. Now I know what to expect, I can at least prepare for it. Lying on the couch however, and not having the energy to do anything was very depressing.

Fiona seems to be doing fine. She said she's felt sad at times when she sees me looking sick but that it also made her "feel tired" when she saw me sleep (so being a typical teenager she would take advantage and have a nap also.) She will be 16 in 2 weeks, and when asked what she wants to do for her birthday she says, nothing. Unfortunately her birthday will fall between my next cycle, as my treatments will be on the 31st and 7th, so I'm probably not going to be too much fun.

In 3 days we should have been on our way to Australia for our much needed month long vacation. I guess it's just postponed and we'll do it some time in the near future.

A couple of positive notes to end with: having no hair saves shampoo and conditioner, but the biggest advantage is the time it saves getting ready in the morning, no blow drying!!

Again thanks to everyone for everything.

Karen

Amazing

It's now been one week since my last chemo and I am scheduled for the second part of cycle #2 tomorrow. (the trail drug gemcitabine.) I am still feeling pretty good, fatigue and diarrhea are my only major problems this time, so we'll see how the cumulative effect is after tomorrow. I'll then start cycle #3 on the 31st.

Being bald no longer scares me when I look in the mirror, can't say I like it, but I am getting used to it, one day I will post a picture. I am still going to work as much as possible, although it is frustrating not being able to do patient care, I so just want to work and be normal and this doesn't allow me do such.

On a positive note, my tumor has shrunk considerably after the first treatment. It is now difficult to palpate, amazing after only one cycle. I told you I was going to kick its ass.

I'll try and write a little more often, but when I get home from work I just want to veg out and lay on the couch.

Karen

AKA Kojak

Back from my trip to Costa Rica. Rebecca and Adam's wedding was beautiful and we had a lot of fun, it was lovely to see two people so much in love. I felt very well while I was away, no heartburn, no fatigue, aches or pains, the only thing was an upset stomach on a regular basis. I wore a mask on the plane and of course got many a look, my god has no one ever seen Michael Jackson, at least I looked better than him. I tried to avoid getting mosquito bites, (due to an outbreak of Dengue fever spread by mosquito's) so used lots of natural repellents and minimised the bites. Fiona let everyone know she got 16 bites the first night. I really just relaxed, soaked up the sun and ate good food, seared ahi every night (tuna for you foreigners).
They said my hair would start coming out around day 14 to 21, they were dead on about that, basically coming out in handfuls starting on day 15. I know it's only hair but it really was quite distressing to see so much come out with washing, brushing sleeping etc; within 2 days I'd probably lost about half of my hair, today I got fed up and had Fiona shave the rest off, so I can now go by the name Kojak. ( no pictures of this new style) This is probably the first time I've seen Fiona clam up and be upset, I don't look like me according to her and she "doesn't like it."
I should have had my next treatment tomorrow, however I changed it to Thursdays so that I can work Mon, Tue Wed have treatment Thursday and recover Frid, Sat and Sun, so that is my plan at the moment and looking forward to continuing the party.
Again thanks to everyone for everything, without all the support and words of encouragement, this woould be a much harder battle.
Karen xx

#2

Its now been a week since I received my first chemo treatment and I, have been feeling pretty good. The first few days I was really tired, falling asleep in the mid afternoon or early evening, but that seems to have improved over time. I have also been getting lots of heartburn pain, lasts for many hours and seems to be something I get on a daily basis, certainly worse with certain foods, so now trying to stay away from anything that can exacerbate it , I am, however on medication to help prevent it. No real nausea, occasional diarrhea, mouth getting dry and sore. My skin on the other hand is like a teenagers, breaking out, and of course I just want to pick and squeeze. Anyway if this is as bad as it gets then I'll be happy, somehow I don't think it'll be this easy.
Today I was scheduled for next treatment, gemzar, which is part of the research protocol. Prior to all treatments blood is drawn and checked, today, unfortunately my white cell count had dropped (WBC) normal 4.1 to 10.9, mine today, 1.3. WBC's are there to help fight infection, I therefore am more prone to any infection which can make me really sick. They therefore decided to cancel chemo today and I will get it again in 2 weeks, by then the count will be up. I was also given a drug called neulasta to help build up the calls again, and on my next chemo treatments they will give me something to keep the count higher. I guess it's all part of the ups and downs that go along with this.
Going to Costa Rica on Thursday will definitely be difficult and I will have to be really careful, the plane is my biggest fear, recycled air. However it is probably good that I never got my treatment today, because if I did and then went on vacation, I'd probably get sick. I am really looking forward to going away , I have a long road ahead and a trip away will be "just what the doctor ordered".
I'm still feeling very positive and everyones prayers and good wishes are helping . Thanks for all the cards, calls, prayers, food and to Julie for her gardening skills. Karen xxxx

chemo

Had my first treatment yesterday. Met with the doctor first, he told me he was disappointed that I never got on the B arm of the study however there are still good results with the Gemzar, and if the tumor didn't respond then we'd look at other options.  He did mention that it was the toughest of the drug combinations, I think he meant side effects.

Prior to starting the medication they gave me benadryl  and tagamet as the docetaxel can have a significant immediate allergic reaction, these were given to minimize any effects. So with only 2 hours sleep the night before I managed to snooze with a little help from the benadryl. 

 I must admit it was emotional starting the treatment, I guess reality set in, but on the other hand it is the beginning of fighting the disease. The first drug lasted just over 2 hours with no ill effects. The second drug Gemzar burned like hell, you could see the white streaks all the way up the vein, we had to wrap the arm with a hot pack and dilute it more. So that vein is now shot. Hopefully it won't be so bad next week.  Yesterday and today I felt fine, a little tired at times but otherwise ok. Had to have IV fluids this am and drinking plenty of water, this will be repeated after every treatment, just to flush out the kidneys. It seems most of the side effects, nausea, fatigue and joint pain will happen within next day or so, although it is very individual, so we'll see. I actually went into work and did chart Quality assurance for 4 hours. The more I can work when I feel well the better.

Thank you again for all the love, support and encouragement. It is awesome. Karen

New haircut

 

I've had such a busy weekend that it has been great with little time on my hands to rest and think. Got my hair chopped Friday, cut and colored, I figured I may as well do something fun as it will start falling out 14 to 21 days after the first treatment. As long as it doesn't fall out before my friend Adam and Rebecca's wedding I'll be fine! I will enclose a picture at some point when I am able so that you can all see me with short hair. 

Went to Rebecca's bridal shower Saturday and had lots of fun, as did Fiona. Her comments, "they are a fun group, Costa Rica is going to be interesting" Yes it is!! . Sunday I  spent cleaning all day, had shopping already done so that I was somewhat prepared, lots of light high protein things, I think we bought 16 yogurts, hopefully enough! I then had a night out with friends at an Italian restaurant which was great, I had originally planned on having a pre chemo party with friends so that I could get plastered before, but probably not a good idea to start chemo with a hangover. So here I am at 1.30 aftr going to bed at 11.30, maybe its the decadron I was to take before 5pm, took it 11pm. Oh well I will sleep plenty after 1st treatment.

I can't begin to say how I feel about all the support and good wishes I've had. Everyone has been wonderful, I never knew so many people cared, it's truly overwhelming. I love reading the comments everyone is posting and of course I end up crying when I read them. 

So its chemo in a few hours, and just the beginning of the fight.

Love you all. Karen

Moving Forward

Well now that I know what the plan is it was time for lots more tests. I had an EKG and echocardiogram to check my heart. Some of the drugs can damage the heart so they like to look before chemo starts. I then had a pet scan to check that nothing had spread to other parts of the body, then an MRI of the breast to have better images.

I then had another biopsy for the study as they needed 4 samples, now that all the tests were done it was now time to randomise me for the trial. The computer basically decides what arm of the study you'll be on. I was so hoping for the B arm as the drug avastin has been found to be promising in late stage cancers. I was however randomised to arm 1c. 

So what does all that mean. Well I will be on 4 different IV chemo drugs. On the first day of each cycle I will receive docetaxel and gemcitabine, then I will receive the gemcitabine alone a week after the first dose. This will happen once every 21 days for 4 cycles. (The gemcitabine is the study drug to see if its better than the usual combination)After the 4 cycles are complete I will do the second round of drugs adriamycin and cyclophosamide every 21 days for 4 cycles. After the 6 months of chemo it will be time for surgery. 

Things are moving so fast really don't have time to think too much, call it denial if you want.I really wanted to wait and start all this after I came back from my friends wedding in Costa Rica, however the Dr said no, he had wanted to start the following week. So I am starting chemo bright and early Monday am.

Dr visit

Saw Dr link June 5th and we sat and talked about diagnosis and treatment plans.I have a large 6cm tumor that has spread to the lymph nodes. It was staged as a stage 3. Breast cancer has 4 stages, 4th being the worst. He did say I have a fast growing aggressive tumor that usually responds well to chemo so that is the plan attack it hard and fast. Kill that sucker.

It was a good visit because now I could at least move forward. I was offered the opportunity to be a part of a research  study looking at a newer drug and also looking at different combinations of drugs. The goal is to have a complete response to chemo before surgery. So now that I had a plan and I had already decided to be a guinea pig it was now time to get the word out and tell family, friends and co-workers.

Wow, telling my family my diagnosis was probably the worst thing I've ever had to do, hearing their reactions and pain was heartbreaking and it just got harder the more phone calls I made. I let the word spread at work so that now it is out in the open. Everyone has been wonderful and soooo supportive so that has been a positive.

As for me I'm still rather numb, still can't believe it's me I'm talking about. I really don't sit and dwell on it however, and I truly believe I will beat this and be cured with no recurrence. I have to believe that as I have a beautiful daughter who needs me. I know the next few months are going to be tough as the Dr told me. Bring it on.

How did I get to this point

 As most of you now know I was recently diagnosed with breast cancer. I thought I would use this forum to write a little about what is going on in order to keep you all informed, so here goes.

Over the last few months I noticed the shape of my right breast had changed slightly, like a small depression quarter sized, nothing drastic, nothing to worry about or be concerned about. I did my usual exams never felt a lump and I was already scheduled for my routine physical with Dr Ryan. I brought it to her attention, she did her usual exam and never felt anything, so I went ahead and scheduled my annual mammogram. If it wasn't for Dawn Marie nagging me to get it scheduled I would have probably waited a lot longer to do it. However I did schedule it for 4 weeks later and had arranged to meet Dawn Marie for lunch after it was done as she also had appointments all day. I had the boob squishing done and the mammographer stated I had calcifications, ok, no big deal, I knew I had dense boobs, just like my brain at times and certainly now. So I then proceeded with ultrasound and then she said I just need to have the Dr review it. I was totally oblivious, in la la land I guess, so the Dr said you have a suspicious lump. Oh! we need to do a biopsy. When a Dr asks for a 10 guage and 14 guage needle and wants to poke your boobs with it, just say oh shit! So that was that, I had the biopsy done and she told me she was 98% sure I had breast cancer and gave me a book about breast cancer. I thanked her and walked out numb, not a tear shed until I saw Dawn Marie, then the water works started.

The next day I was called by  Dr Ryan to say the biopsy was positive and I had a high grade aggressive tumor. I really still didn't believe it, I am young (ok I'm not 20) healthy, active, hard working and no family history of cancer. I then went about scheduling appointments so that I could figure out plan. I, at that point told my daughter and a few good friends. Otherwise I wanted to keep it under wraps until I knew what was happening. Work was a god send because at least I could focus on something else, so I carried on as normal putting a face on and not really thinking too much. By this time I was well read and informed and was just really looking forward to seeing oncologist and a getting plan of care.