This blog documents the journey of Marla Crider, a 60 year-old travel professional from Little Rock, Arkansas, as she battles a breast cancer called invasive ductal carcinoma (stage 3). From the moment of her diagnosis, she chronicles her experience. Be forewarned this blog may provide a raw glimpse into the author’s psyche and ability to deal with a life threatening challenge. Hopefully, her honesty and humor will provide advice and help to others who find themselves in a crusade of their own.
Monday, July 21, 2014
Bumpity, bump, bump.....
Sometimes, it seems, things just aren't meant to be, such as
my July 14 appointment at M.D. Anderson Cancer Institute in Houston.
Several weeks after my UAMS oncologist, Dr. Issam Makhoul,
made the arrangements for me to see the cancer team at M. D. Anderson for
possible inclusion in a trial drug protocol and/or new treatment program, I
noticed six to eight hard, pea-sized nodules on my scalp. Since my appointment at M.D. Anderson was
still more than three weeks away, I decided to call Dr. Makhoul’s office and
tell his nurse, Brenda, about the bumps on my head. It was Friday afternoon.
She told me that Dr. Makhoul was out of town but she would let him know the
first thing Monday morning.
Marla and Don - July 4, 2014
After fighting cancer off and on for more than a year, I
knew that the bumps on my head, and now a new one on my back, were related to
the metastatic breast cancer. Having
cancer improves one’s health instincts. More times than not, the least little
change in the body is usually a pretty good barometer that something isn't
right. Late Monday afternoon, I finally received a call from UAMS. It wasn't Brenda, Dr. Mak’s nurse; it was the
good doctor himself, which alarmed me just a tad.
When I answered the phone, Dr. Makhoul wanted me to know
that he had placed a call to M.D. Anderson Cancer Institute to inquire why my
appointment was scheduled more than six weeks after he requested their medical
team see me. He promised to contact me
after he spoke to someone in Houston.
About an hour later, Dr. Makhoul phoned me to share what he
had learned. It seems that M.D. Anderson
recently changed its policy when accepting and scheduling patients. Texas
residents are seen first, followed by patients from other states, then
international patients. Since I’m from
little old Arkansas,
my appointment was delayed for six weeks, without considering how aggressive
the cancer had become. Dr. Makhoul was incensed that no one from M.D. Anderson
had notified the UAMS oncology department about the new policy, especially
since the doctors there refer lots of patients to them. The oncologist with whom Dr. Makhoul spoke
went on to tell him that I wasn't a candidate for any of the trial treatments
being offered and he encouraged Dr. Makhoul to continue treating me in Little Rock.
Dr. Makhoul told me that we could no longer wait to start a
new treatment plan. He directed Brenda
to schedule an appointment for me on Wednesday, as well as time in the infusion
room for chemotherapy. Things were
moving fast, as they always seem to do with cancer treatment. I must admit that I was actually relieved to
learn that the appointment at M.D. Anderson had been canceled and I was back in
the hands of the doctor I trusted the most. Even Don was satisfied with the
current turn of events. He understood
the urgency and was ready to stand by me, yet again, as I endured another
series of chemo treatments.
As they had done a year earlier, my brothers decided that
one of them would be with me for each chemo treatment. My older brother, Mike, and sister-in-law
Barbara, drove from Springdale in Northwest Arkansas for my first treatment. As I have mentioned before, family support is
key for those of us battling cancer.
Never will I ever be able to verbally express my gratitude and unconditional love for the sacrifices of time and travel mine has provided me.
We all arrived at UAMS for my appointment with Dr. Makhoul
to learn what his plan of action would be.
It was early enough in the day that I only had to wait for an hour
before seeing him. When Dr. Mak entered
the exam room, I was very glad to see him.
It had been more than a month since we had talked about my
diagnosis. The first thing Dr. Mak did
was examine the bumps on my scalp, as well as the one on my back, and
acknowledged what I already knew; the cancer was spreading…quickly.
Back in the Infusion Room
The plan included a double whammy of carboplatin and gemzar
– two chemotherapy drugs that Dr. Makhoul said had rendered very good results
for other patients. It may seem odd to
be excited about taking chemotherapy, but I was. It meant that I was no longer going to have
to sit idly by while the cancer cells dined freely on my liver, lungs and
My family, Don and I made our way to the very familiar
surroundings of Infusion 1, located on the first floor at the UAMS Cancer
Institute’s Outpatient Clinic. As usual, the waiting room was almost to
capacity and our wait was long. When my
name was finally called, I almost skipped to the recliner where I would begin
How appropriate that Mr. Nurse Ratched would be the RN
assigned to administer the newest round of chemotherapy. He greeted me with a
smile and requested I tell him my current status. When I shared that the cancer
had spread to my lungs, liver and pelvis, he said, “Yep, that’s where breast
cancer likes to go, but rest assured Dr. Makhoul has an arsenal of chemo drugs
to get you back on the right track.” I
was somewhat surprised that Mr. Nurse Ratched was actually trying to make me
feel better. Who knew that the guy was
capable of compassion?
As Mr. Nurse Ratched prepared to start pumping the
intravenous poison into my system, I noticed two new RNs in the infusion room –
both were male. I remarked that it
appeared he was no longer the token male in Infusion 1. He replied, “Yes, I have two new roosters in
my hen house.” I laughed out loud. My nemesis with the questionable bedside
manner had acquired a sense of humor since our first encounter more than a year
Mike and Barbara shared “sitting” duty, while the carboplatin
and gemzar dripped into my bloodstream, each drug taking approximately 30
minutes. Mr. Nurse Ratched told me the usual side effects from the drugs were
fatigue, constipation, and a possibility that my blood counts might be
affected. Some hair thinning was also possible.
I have determined that side effects are what you allow them to be and I
refused to let them interfere with my daily routine or my job. Dr. Makhoul scheduled me for chemo two
consecutive weeks, then off the third week to allow my body to recover.
Fatigue and a few achy bones were the side effects that I
noticed after the first treatment. Also,
I was experiencing some insomnia. Even
with that, I felt blessed that the side effects were minimal and prayed that
this would be the norm, not the exception.
Treatment number two was scheduled on July 3. My middle brother, Marion, and sister-in-law
Carolyn journeyed to Little Rock
to provide support. Don was expecting 19
family members for the Fourth of July, so we agreed that he should spend time
preparing for the mass of people and leave the care giving duties up to Marion
and Carolyn. Whether necessary or not,
it is always comforting to have family nearby, should something unforeseen
The most important thing I observed after the second
treatment was that the bumps on my head were all but gone. The nodule on my back was still noticeable
but felt smaller. I was ecstatic. After only two treatments, it was apparent
the carboplatin and gemzar were killing the cancer cells! God bless Dr. Makhoul!!
My miracle worker of a doctor requested to meet with me on
July 18 - week three - to discuss my progress.
This time, it was Mike and Barbara’s turn to make the trip to Little Rock. Since Don’s
ability to walk has become more burdensome, due to numerous knee replacement
surgeries and old sports injuries, I encouraged him to let my family do the
walking, sitting and waiting with me and he agreed.
Mike decided to accompany me to meet with Dr. Makhoul. As
usual, the wait took about an hour. In
his usual hurried state, Dr. Mak entered the exam room anxious to hear how I
handled the first two treatments. When I shared that the bumps were gone, he
almost didn’t believe me. He requested
that I sit on the exam table for a quick check of my heart, lungs and bump
patrol. To say that Dr. Makhoul was
surprised and elated would be an understatement. He was almost giddy.
I told him that I was hopeful the chemo was working as hard
to destroy the cancer cells internally as it had done externally. To determine if that is the case, Dr. Mak
scheduled a PET scan for August 4 that will provide the answer. He ordered the third round of chemo and
confirmed that I am still his poster child for chemotherapy because my blood
work is excellent and the side effects are manageable, which is uncommon for
the type of chemo I’m taking.
Before Mike and I left the exam room, I heard Dr. Makhoul
use the “R” word – remission. He
enthusiastically told me he had several patients who had experienced remission
after receiving the one-two punch of carboplatin and gemzar and I might just be
one of them. I could feel the warmth of
God’s embrace after that comment and even heard a faint “praise the Lord”
coming from the direction of my brother.
As I sat through the 90-minute intravenous drip of my two,
new best friends – carboplatin and gemzar – I prayed silently that the “R” word
would trump the “C” word and become a frequently spoken description of my
health status. I certainly don’t want to
get ahead of the PET scan results, but I keep repeating the word…remission. It has a nice ring to it, doesn't it?