Tuesday, June 30, 2009

It's about time...

I admit it -- I've been neglecting my blogging duties and it's about time I posted another entry. Actually, several of you have been kind enough to get in touch with me and inquire whether everything is alright. The good new is that yes, everything is indeed alright. I've been feeling pretty well (with the exception of Monday, when I had some seasonal allergy issues) and doing all kind of things. So I was too tired at night to post an entry. 

On Friday, I had my first monthly appointment with the poison man. As it turned out, I didn't need to donate copious amounts of blood for analysis, but only the small vial full for the CBC that they 'milk' out of my fingers. Although I was only one week post-chemo, my values looked pretty good, as it turned out. Actually, they were all within normal range, albeit some at the lower end of the range. That's excellent, really, as it means that the Neulasta is doing its job and my body is still able to fight infection. The poison man also seemed impressed that after two rounds of chemo, I was not (yet?) anemic, which made me happy as well. The rest of the exam consisted of a physical examination and lots of questions about my side effects. Dr. V agreed that I was doing really well with the chemo and that we'll continue as scheduled. Thus Friday's appointment went very well. And today we received the Neulasta shipment from the mail order pharmacy, which means that Thursday's chemo can proceed as scheduled, and I can administer the Neulasta shot myself on Friday, when the Cancer Center will be closed. Yay!

The weekend turned out to be nice and sunny, so DH and I spent lots of time in the back yard, watering, deadheading, and just wandering around and looking at the various flowers that are blooming. The clematis is still going strong, the hydrangea is getting there, and the window boxes are full of blooms. The garden is also starting to show its bounty: the swiss chards are getting closer to eating size, the tomatoes are setting fruit, the eggplants, cucumbers, and yellow squashes have the first flowers, and the raspberries are coming in at full speed. I might have to make some jam with those beautiful raspberries soon -- and definitely when the blackberries ripen, as they will be particularly bountiful this year. This is a good time of year...

On Sunday, we had our friends 2l and her husband Starman over for lunch. I made something quick and easy, though -- a big pot of Thai-style mussels (with coconut milk and red curry) -- as I don't have the energy for elaborate meals. They brought their dog Bailey with them so that BJ had a doggie friend to play with. It was a really nice afternoon just eating and chatting with friends. DH and I both enjoyed it very much. After a few hours of easy entertaining I was pretty wiped out, though! It really doesn't take much to exhaust me -- which is why I am very grateful I do not have to work these days.

Today I had an appointment with the boob man to be topped off. Now I have a 'whopping' 300 ml foobie (this is as much as the boob man estimated he may be able to get in at my initial filling, i.e. during the mastectomy... so much for estimates!)! Hurray, I'm not as lop-sided as I used to be!!! Right now it has that typical "turtle-shell" feeling as the muscle and skin get sort of hard and stretched after each refill. So in a way, it feels less like the original, but due to its increased size, from the outside it looks more like the original. For the time being, I do not think I will need to cheat and even out the sides. In two weeks I'm scheduled for another topping off session, which will increase my left side beyond the size of my right. I may even go to the full 500 ml size of the expander, which would mean I'd get a very small implant on the right side when they do the surgery to make me symmetrical. I have to think about that one, though. In any case, there will be a time when the foobie side will actually be bigger than the 'au natural' side, as the boob man needs to "overfill" me. Supposedly, this creates a more natural "drape" (not "sag" as DH crudely called it...) once the foobie is completed. Sometimes I am amazed at all those things that I never even knew about, let alone thought I ever would know about... And let me tell you, plastic surgery details were most certainly not on the list...

Once again, DH managed to finish work early and come home in time to accompany me to the boob man. He even got to witness the amazing foobie inflation. Oh, and did I mention, I even managed to look this time -- but only after the needle was in -- and watched how the boob man topped me off. It's kinda neat to watch, actually. In any case, it was really sweet of DH to come, as he originally thought he may not have the time. It's so nice to have him there, though, as go from doctor to doctor. I really appreciate how he has been taking the time to spend with me and drive me around, not to mention to feed his little baby bird.

So I have one more good day, tomorrow, before the roller coaster starts hurling downwards again on Thursday. It will be round three of my four AC chemos. After that, I will start the T, i.e. the taxol. Hopefully the side effects of that regimen will be as tolerable as the AC has been for me. Nonetheless, this time it's psychologically harder to get ready for the next round. I feel pretty good, which makes it all the harder to know that in two short days it will all be over and I'll start teetering on the edge of nausea again. Mind you, the nausea isn't that bad, but still I get tired even faster after the chemo, and I need to eat ever two to three hours in order not to get nauseous. Sometimes I just feel that it's such a pity that there is no continual improvement, but merely the roller coaster of the chemo cycle. But I tell myself that at least I am on a dose dense schedule, which means that I'll be done with chemo in merely four months. This isn't forever, just for a few months.  What's a few months of my life compared to the chance at a cure that this chemo gives me, right? Nothing -- nothing at all. So I'll enjoy tomorrow the best that I can, and on Thursday I'll get ready to kick some more cancer butt!!! Because it's about time ... that I evicted cancer from my body completely! I'll have to remember my chemo battle song...

Thursday, June 25, 2009

On the up and up

It has been a week since my last round of chemo, and I am on the up and up. My energy is returning again and I am getting more stuff done. I took the doggie for a longer walk this morning, managed to do two loads of laundry (and even folded and put away the stuff!), and make dinner. Come to think of it these are really just chores I'd normally do without thinking much about it -- and squeeze them inbetween other stuff. For right now, however, just managing to do my chores feels like a pretty good achievement. I guess the chemo is getting to me more than I sometimes care to admit.

Tomorrow I am going for my first monthly checkup with the poison man since the beginning of chemo. I am curious to see whether they can tell if the chemo is working for me. Of course, this may necessitate another blood draw (and you know how much I love those...) that may go beyond the traditional pre-chemo finger stick and milking they do for my CBC. But then my veins have had an opportunity to recover from the insults to which they have been subjected in the past few months thanks to the port. So I do not actually have track marks any more, nor bruises, which should make the blood draw much easier. 

That's the news from my little chemo world. Nothing much, really, but I do love it when the rain finally stops and the sun shines. Just reminds me that I definitely do need to call to get an estimate for installing split airconditioners in the house. Although my hair is gone, I get hot really fast which makes me feel very uncomfortable. So I'm thinking I really do need some decent air conditioning in this old house this summer -- and not just some of those roaring monsters we normally put into the windows.

Oh, I just remembered one other piece of news. The doctor's office finally called yesterday to tell me they sent my script for neulasta to the specialty mail order pharmacy I need to order that sort of stuff from. The pharmacy, in turn, was supposed to call me within twenty-four hours -- but never did. This is curiouser than all getout. If my brain isn't too foggy, I am going to have to follow up on that tomorrow. Sigh, yet another complication just to stay on schedule with my dose dense chemo...

Wednesday, June 24, 2009

TNBC

I've been promising you this entry for a while, so I thought I'd finally tackle it and explain what exactly triple negative breast cancer is, and why I chose to go through the toughest chemo treatment in town even though my breast cancer was caught at an early stage. Please note that the below is my personal understanding of the medical background/situation. I am not a medical doctor, nor should any of this entry (or this blog, for that matter) be taken as medical advice.

With the disclaimers out of the way, let me start at the beginning, then. Back in the olden days, scientists and clinicians only distinguished cancers based upon where they originated. In other words, back then doctors treated breast cancer patients as one monolithic group. Women would be treated with surgery, perhaps radiation and chemotherapy. The first of these treatments are known as localized therapies, as they affect cancer cells only the body part at which they are directed (in this case, presumably, the breast). Chemo is different in that it affects all rapidly dividing cells within the body, including cancer cells wherever they may be hiding in the body, which is why it is known as a systemic therapy. But systemic therapy is tough to go through, has potentially toxic side effects, and for most early stage cancer patients does not provide terribly much of a survival benefit (I'll explain why below), so chemotherapy was not (and in many cases is not) a terribly common treatment for early stage breast cancer.

Over time, however, doctors came to realize that not all breast cancers were alike, nor responded equally well to treatments. This was the beginning of a sea change in oncology where doctors tried to identify specific characteristics of a cancer and tailor treatments that attack the cancer cells only -- without the many drawbacks of chemo. Thus began the era of "targeted therapies" where women are treated with medicines specific to their subtype of cancer. Developing such medicines, however, naturally depends upon understanding what makes a particular subtype of breast cancer grow. From what we know today, most kinds of breast cancer are susceptible to female hormones, which is where medicines such as Tamoxifen and aromatase inhibitors come in. 

Triple negative breast cancer, on the other hand, gets its name from the fact that it is a kind of breast cancer that is not fueled by one of the three factors that are known to promote tumor growth: estrogen, progesterone, and human epidermal growth factor/Her2neu. Actually, nobody is quite sure what makes those cancers grow. As a consequence, there are none of those fancy and effective new medicines (including Herceptin for Her2neu positive breast cancer) that can help women with TNBC. 

So in a way, women with TNBC have not been able to benefit as much from medical progress as women with more common kinds of breast cancer have. To make matters worse, TNBC tumors tend to grow much more aggressively than hormone-dependent lesions, which can take a decade or more to grow to a palpable size (Her2neu dependent tumors also grow aggressively, but Herceptin has become an effective tool against them). This is why many women with TNBC are in a more advanced stage of breast cancer when they are diagnosed and their tumors tend to be larger (mine, for instance, was 3.1 cm, which is huge compared to other breast cancers). TNBC also tends to hit younger women rather than older ones, and in those it is particularly aggressive. Oddly, it is also more prevalent amongst African American and Hispanic rather than Caucasian women, and it tends to be even more aggressive in these groups.

Finally, TNBC not only grows faster than other forms of breast cancer, it also has a higher likelihood of coming back and metastasizing -- which it likes to in the brain and other soft tissues. Once that happens, there isn't terribly much that modern medicine can do -- as a rule metastatic TNBC is a terminal diagnosis. This helps explain why the prognosis for TNBC patients is considerably worse than for other breast cancer patients. In one study, for instance, 94% of hormone dependent breast cancer patients were still alive after five years, but only 80% of their TNBC counterparts. 

TNBC thus is a formidable foe -- and in fighting it there are no second chances to win the war. Winning the battle and winning the war are essentially the same thing.  This means that once you have TNBC, it is  even more vital than for other kinds of breast cancer that the every last cancer cell be eradicated so the disease cannot recur and metastasize.

Although TNBC has a poorer prognosis than other cancers, its aggressive growth pattern also makes it a more promising target for chemotherapy than other, more slowly growing breast cancers. After all, chemotherapy kills any and all fast growing cells (this is why many chemotherapies lead to hair loss). More slowly growing cells, on the other hand, are less affected by chemo. Thus the aggressively growing TNBC responds better to chemotherapy than other breast cancers, especially in young women where the cancer is particularly virulent. 

The upshot of all of this is that I have a rare kind of breast cancer that carries a poorer prognosis than other kinds. Given that I caught this disease when I was only 38 years old, and given that this cancer is particularly aggressive and lethal when allowed to metastasize, it needs to be treated as aggressively as possible. Even in cases such as mine where the cancer was caught relatively early (stage IIa) and where it had not spread to the lymph nodes, the prognosis is poorer than for hormone-dependent breast cancers. I do, however, have this one opportunity to evict TNBC from my body for good -- and aggressive chemotherapy is the only way to do it.

So my odds are pretty good if I manage to get the cancer now -- and not so good should I fail to evict all of the cancer from my body. Thus it would be unwise to opt for anything but the toughest, most aggressive chemotherapy around. There really was no other option that made sense, which is why I told my poison man to give it to me as good as a my body can take it. He offered me different choices, but each 'easier' chemo option comes with a lesser survival benefit. And I really, really want to live, which is I selected what has been shown to be most effective against TNBC: dose dense ACT chemotherapy. 

Yes, it is a tough regimen. It puts my body through the paces. But see, I've got plans: Among other things, I have been wanting to have a family and raise kids (well, ok, at this point I'd be very happy with just one kid). But generally, being alive and reasonably healthy is a precondition for having kids in the first place. So I have to do everything I possibly can to fulfil that dream of having a  baby -- and then I need to do all I can to actually hang around and raise the kid.

As you can see, there really was no alternative. I simply had to choose the path that gives the me the best chance of survival and realizing my dreams.  At the end of the day, it's as simple as that. 

Tuesday, June 23, 2009

Why I like Tuesdays better...

Now I remember, this is why I like Tuesdays better than Mondays: the nausea gets better!!! Oh yes, and my energy levels gradually rebound, which also adds to the day's appeal. How could I forget? Well, I suppose I will have at least two more opportunities to remind myself of the particular nature of this chemo roller coaster. Maybe I'll figure it out by round four -- just in time to be confronted with an entirely different kind of chemo from round five on, which is sure to bring its own dynamics, side effects, and challenges.

Yes, as you can surely tell by now, today was a much better day for me than yesterday. My nausea could be controlled by regular baby bird feedings, the sun came out for a while, I played ball with the doggie for quite some time (boy did we both like that!), and I even managed to make dinner for a second night in a row. To top it all off, I managed to find the energy to tidy the house some more and improve upon my mess in progress. So I'll count this as a successful day indeed, even if much more work needs to be done. 

In the next few days I want to work on getting more walks in, and maybe begin lifting some light weights or something to re-build my strength. See, one good day is enough to make me kinda ambitious! Hopefully both my body and the weather will cooperate. 

In the meantime, I am still waiting to hear back from the Cancer Center regarding my next chemo on July 2. The nurse had said she would call me back today to let me know whether I would give myself the next neulasta shot, or whether they want me to come in on Sunday the 5th to receive it at the Center. Presumably the only holdup to the self-administered shot is the insurance, which may refuse to cover the medication in an at-home setting. Still, I find it vaguely unsettling that I have not yet heard back from the nurse. Oh well, what's a little more uncertainty in my life... Maybe this is yet another thing that will happen tomorrow. 

Who knows, given my ambitious plans, maybe I'll like Wednesdays better yet than either Mondays or Tuesdays? I'll let you know tomorrow how close reality came to my ambition.

Monday, June 22, 2009

Just another foggy Monday

Seems like the Monday after chemo is the day my brain gets all foggy and the nausea comes back. Funny how that happens. Well, it wasn't that pleasant, but I made it through the day. Apparently, taking the ondansetron yesterday wasn't such a smart move. I may not have understood the nurse's directions completely, or maybe she didn't explain it clearly enough, but that drug is the last drug I should take when everything else has failed. In other words, when they told me Friday to "alternate" between the reglan and the ondansetron, they might have served me better by saying: "take the reglan first, and if that doesn't help any more, take the ondansetron." But alas, I did not benefit from such clarity of expression -- and ended up with more side effects than I had hoped (thanks for the hint, Daria, I've learned my lesson now!). 

But tomorrow will be a better day, as I gradually learn the ins and outs of chemo. I am sure that there is much more to learn about how to best cope with the chemical onslaught and keep on functioning. Yet despite it all, I managed to actually cook and serve dinner tonight. These days, that's not something I can take for granted any more, so it feels like an achievement of sorts. Cancer sure is giving me a newfound appreciation and gratitude for the little things in life. 

Tonight I actually feel tired enough to make it without the ativan. The dexamethasone must be wearing off, yipee. So I'll try to get a decent night's sleep without chemical help and give my body a chance to recover from all the meds I've been throwing at it. After all, this entry reads more like something a pharmacist would write than something that comes out of my mouth... Yikes!

Sunday, June 21, 2009

My first bald day

Honestly, being bald isn't that bad. I still feel much freed from my shedding head of hair and am glad to have tamed it. The hats and scarves and the wig help me cover up when I feel the need to do so. When I venture out in public, for instance, I feel better wearing the wig. But at home, around the house I often go bald when it is warm enough and only don a headcovering when it's too cool for my comfort.

The nausea has also been at bay all day, but started to rear its ugly little head a bit more tonight as I had instructions to stop all regular anti-nausea meds today, with only the "rescue" drugs left at my disposal. So I took an ondansetron, one of the new rescue drugs that they gave me because I heard lots of bad stuff about the reglan they had previously prescribed. Luckily the nausea is getting better and I am getting tired. 

Tomorrow I have to call the Cancer Center and my poison man to find out whether I can take my next round of chemo on July 2, as planned. As it turns out, the center will not be open on the third due to the upcoming Fourth of July holiday. As the holiday falls on a Saturday this year, they want to give people the day before the holiday off so they can travel. This means they won't be able to give me my Neulasta shot, which may impact my overall chemo schedule. On Sunday they'll open to make up for the closed Friday, so I'm hoping they will either let me inject myself on Friday (after all, since the IVF cycle I've become the queen of subcutaneous--and even intramuscular-- injections, or whether I can get the shot on Sunday and still go ahead with the next chemo on July 16. So there are more details to work out, as always...

But I'm tired for tonight, so I think I'll just sign off now. Goodnight!

Saturday, June 20, 2009

Bit the bullet!

As I have told you these last few entries, my hair has started falling out -- and that process has been rapidly accelerating. Last night the "fallout" was so great that it started bothering me as I felt my hair slip down my shoulders and glide down my arms. So I decided that today was the day to let go of my hair. DH was nervous to cut it all off for fear of hurting me, but with a variety of tools and a common effort we did the deed. We shaved my head entirely! So I am free from falling hairs now (well, at least the ones off my head...). Yay.

It was simply time to let go as it was going to happen anyways. And this way the exact timing at least had some element of choice for me. Actually, I found it much easier to let go of my hair than I thought I might. Secretly I had feared that I may have a few emotional moments as it came off. But instead, I found the process to be strangely freeing as I had become self-conscious about the the trail of hair I was leaving behind. Come on, how can a girl shed more than the dog! That's just not right. 

Plus, I was glad that I had previously shortened my originally longer do to a pixie cut. Still, since I have (or should I say "had"?) very thick and very dense hair, it was quite a bit of work to take it all off. DH had to utilize various hair scissors, clippers, and finally his trusty electric razor to get it all done to a fairly smooth bald pate. It actually took us most of the morning to get me suitably bald on top.

As the hair came down, I noticed how much greyer my hair was than it was just a few months ago. Cancer and chemo are rather strange things that I imagine are even stranger for younger women than for older ones. In a rather odd way, it puts your life and your body in a bizarre fast-forward mode where you age more quickly than you normally would. Not only does a cancer patient, and particularly one who has TNBC, face the prospect of a considerably shortened life span, but the aggressive treatment also puts a girl's body through the paces. Those five surgeries in two and a half months have taken their toll. I am no longer the active woman who was a in pretty good shape for her thirty-nine years of age that  I was just a few months ago. I am a much weaker, less toned, and markedly scarred version of myself that is now bald,  as well. 

Still, the hair loss wasn't that bad, since unlike the scars its effects will not be permanent. Plus, I was relieved to find out that while my skull is kind of squared off and almost angular, there are no really weird bumps or patches or birthmarks that are now glaring of my bald pate. I certainly look very different, but not in an extra bizarre way -- if that makes any sense. In a way, it actually looks kinda cute -- particularly with big earrings and some makeup, I would think. I'll have to try that out sometime.

With the hair gone, I also got to play around with my wig and the various head coverings a bit more. I have amassed a little collection already and now got to try it out for the true fit. The coverings my mom made for me worked beautifully. I'll have to make some more out of the remainder of the fabrics we bought together.

Also, I like my wig a lot better now that my own hair is gone. I had grown concerned that the wig was too small/tight on my head and would give me a headache. However, with my thick tresses gone, the fit was much, much better -- so much so that for trial purposes I wore it most of the afternoon without experiencing too much discomfort. DH even convinced me to go to the grocery store with him, which I did. I didn't feel one bit self-conscious about the wig. Now I'll just have to go back to my hairdresser and have her shorten the bangs for me a little bit.

Also, I am still awaiting delivery of the second wig (in a hairstyle and color a bit closer to how I have recently worn my hair). Once that comes in, I'll actually have to different hairstyles to choose from. This could be kind of fun. But when it gets warmer, and around the house, I am starting to find that going bald may be the best way to go. Still, for work I think it will be much more appropriate to wear a wig, so it'll be good to have some decent ones.  

So that's my big news for the day. The TNBC details will have to wait for another day. But first I've got to get some more rest. The one half Ativan I took last night helped me to one and half more hours of sleep than the night before. So tonight I got daring and took a whole tablet. Hopefully this will get me even more rest that will do for a good night's sleep. So I'll sign off now, glad that the bullet has been bitten -- and once again it wasn't as difficult as it might have been. This is yet another thing for which I can be grateful today. I told you I was a lucky girl...!

Friday, June 19, 2009

Lucky girl

It looks as though round two of AC chemo really brings less nausea than round one did. I am one lucky girl. There are the occasional twinges in my stomach, but a bit of food and the meds take care of those. The dexamethosone flushes my face a bit and keeps me from sleeping for more than four hours a night, but hopefully the Ativan they prescribed will fix that. I'm fatigued, ov course, but that just means more rest which I can luxuriously afford to do. Got a bit of chemo brain, particularly the first few days after treatment. Still dry eyes and mouth, but nothing unbearable that eye gel and a special mouth wash can't fix. Overall my chemo side effects have been really tolerable. I am so grateful for that!  

Today I was a bit grumpy since I didn't sleep that much (sorry DH, it's the meds speaking...) but tonight I felt good enough to go on a nice long walk with DH and the dog, which really lightened my mood. I need to exercise more -- maybe even start up a light yoga practice again and some modified weight lifting to get the muscles back into shape. They say exercise is always good for me, but particularly now. So that's one of the things I want to work on over the next few weeks. I really want to get back into a better shape as I haven't been allowed to work out much since mid-March when I was first diagnosed and went through all those surgeries.

My hair is coming out in bigger clumps now although the effects still do not seem obvious on my head. My pillow and the cloud of hair I sometimes leave behind while walking tell a different tale, though. So shaving day is very near, I think. The nurse asked me how I felt about losing my hair when I went for my Neulasta shot today. I told her I was fine with it. It's just hair, and it will grow back. Plus, it might be nice not to have all that warm hair during the summer -- I'll have to watch out for sunburn on my bald pate though (which shouldn't be too tough, as I'm not allowed out in the sun in the first place since the chemo makes me photosensitive).

If anyone who is facing chemo right now happens to be reading this blog, let me tell that two things: First, every body is unique and reacts to chemo and the other medications in unique ways. Second, my experience with chemo really hasn't been anywhere near as bad as I initially feared. All the stuff I have described so far on the blog are little nuisances. To me, they do not add up to a serious decline in my quality of life.  It's not going to be a walk in the park, but it's far from the end of the world as you know it. Sure, there will have to be changes. But what really puts those relatively small changes into perspective for me is that the cytotoxins they're pushing into my veins every other week are good little poisons that will kill all remaining cancer cells within my body. This stuff has a good chance of curing me from this dreadful cancer. And for a cure, I'm willing to take much more bad stuff if I have to. So I am very glad I chose the most aggressive chemo route to beating TNBC.

I think I'll have to write an entry on TNBC in the next few days to explain why exactly chemo is so important for TNBC, as quite a few folks I know kept telling me that with the stage of my cancer I really shouldn't need any chemo, or at least not such aggressive treatment. I know that your comments were really an expression of your concern for me and your desire that I be spared this aggressive and potentially toxic treatment. However, I want you to understand why this treatment is so important for me. So more about that in the next few days.

Thursday, June 18, 2009

I'm hooked again...

Here I am back at the Cancer Center again. I must be hooked or something... Oh wait, I am hooked indeed! Hooked up to the poison pump, that is, for today I am getting round two of my AC cocktail. For right now, all that's dripping into my vena cava is lots of saline with a bit of dexamethasone, a steroid, to combat nausea and prevent an allergic reaction. So I am hooked indeed, awaiting the little poison soldiers adriamycin and cytoxan to be pumped into my bloodstream to ferret out those pesky remaining cancer cells that may be hiding somewhere in my body. I'm so excited that after today's treatment, I will actually be halfway done with my AC chemo, and a quarter of the way done with my overall chemo treatment. Since I'm doing dose intense chemo (i.e. chemo every other week, rather than ever three weeks), I'll also be done sooner than other cancer patients. Yay!

When I came in to the treatment room again this time, the friendly nurse L, who had already poisoned me so nicely last time, welcomed me back with a big smile. It is so nice to see a familiar face when I come for treatment. This time around I'm not being quizzed by the research study nurse, and actually have more time to read, watch TV (thanks again guys for the neflix subscription -- I love it, particulary the streaming content!), listen to music, and write this blog entry. Somehow it feels more peaceful this time around with fewer probing questions about my pain and nausea levels.

As for my hair, the shedding is clearly accelerating. I'm wearing a hat already, not so much to make up for missing hair, but to contain the shedding and keep from leaving a trail of hairs falling to the ground as I pass by. Interestingly, the loss does not yet seem obvious on my head, but I find my hairs everywhere at home. Just running my hand through my hair will produce about two to three dozen hairs today. I definitely think that this weekend I'll have to shave it all off. I just have to make sure that the wigs or haircoverings I wear do not look as fake as some of the ones that my now better trained eye spotted in the waiting area today. By the way, I do not want to sound mean with this comment. It is just that I've learned a bit about wigs and such, and now know to recognize lower quality ones by their unnatural sheen (and the grey hairs sticking out at the nape of a chestnut brown wig...).

Nurse L has now finished pushing in the adriamycin. Last time I sucked on ice chips, but the icy water seemed to upset my stomach. So this time, we brought Klondike bars (with dark chocolate, yum!), which made for much a more pleasant cooling experience. I'm gradually learning the ropes of chemo treatment, I think! Now the cytoxan is going in slowly together with some more anti-nausea meds. I'm on my way to being done with chemo #2! More later.

Update:

It is past 9 p.m. now and I'm resting comfortably at home watching Netflix. DH made dinner for us and keeps feeding me like a baby bird. So far, only small twinges of nausea and aversion to the cooking smells. But that is easy enough to combat by hiding behind a closed door. Sadly, I didn't get to go an evening walk tonight, as it has been pouring almost incessantly today. Instead, I settled on the more prosaic task of doing a load of laundry. Overally, though, I have high hopes that I might manage to make it through the second round with as mild side effects as during the first round. Keep your fingers crossed that the first time wasn't simply a fluke.

Wednesday, June 17, 2009

Let the shedding begin...

They told me this would happen, and they told me it would take about 10-14 days to begin. Apparently I am a bit slow, but starting this morning, I noticed some distinct shedding. I'd been feeling it in my scalp for a day, that itchy pain in the roots of the hairs, and had figured it was the first sign. I was right. This morning, only individual hairs were coming out. By this evening, pulling my hand through my hair is leaving me with perhaps a dozen left in my hand. Given the density of my pixie cut mane, the loss does not yet show. But if it keeps accelerating at this pace, I'll be bald before I know it. Let the shedding begin...

But it turns out nobody ever mentioned that losing the hair would hurt. And I don't mean that figuratively -- of course it "hurts" psychologically to be losing one's hair. I mean that losing my hair actually hurts -- physically. It's not a bad pain -- on the famous hospital pain scale of 1 (no pain) to 10 (the worst pain I can imagine), this one rates perhaps a 0.5. Nonetheless, I am surprised nothing I read on the topic ever pointed out that I would be able to feel the hair come out.

Perhaps this sensation is typically subsumed under the label "scalp irritation." When used my last day of the week with full energy (well, as full as my energy gets these days) to run errands (bank, work, store, grocery store) I put on one of the cute hats I have purchased for my soon-to-be-bald head. I'm supposed to keep the sun off my button nose (turns out chemo drugs also make a girl more photo-sensitive than normal), so I figured a hat would help with that. But boy, could I feel my irritated scalp under that. Hopefully this will subside a bit when all the hair is gone...

Tomorrow I go for my second cocktail hour at the Cancer Center. I suppose that won't help with hair retention, either. So I'm thinking that before the weekend is out, I will have to have the ceremonial shaving of the remaining hair. Since I cannot easily lift my hands above my head, I am hoping that DH will do the honors. Too bad the next few days are supposed to bring more rain, as this rules out the deck for the shaving session and forces my falling tresses into the house.

Oh well, so there goes the hair. I keep telling myself that it's just hair and that it'll grow back. But of course I'm a bit nervous about losing it, even if I bought a wig, head coverings, and hats already and have a second, nicer wig on order. Nonetheless, losing my hair will officially make me look sick and like a cancer patient. But hey, just because I won't have hair doesn't mean that I won't be fabulous any more!!!

Tuesday, June 16, 2009

Ah, the energy

Yesterday I didn't feel so hot as I battled a headache all afternoon, but today was an entirely different story. I had more energy than I've had in a while and finally tackled some stuff I've been meaning to get done. It's the end of the day now, and my desk is cleared of a bunch of customer complaints that I had been judiciously avoiding for so long. The dreaded pile of evaluations I've been needing to write are done. The towering stack of bills is paid. Some letters I needed to take care of are written. And I've started catching up on my emails. Not too bad for me for a day's work -- these days, anyway.

On top of that, I took the dog for a quickie morning walk, and a really long evening walk that included a few steep hills. I think this may be my first post-surgery workout when I've actually worked up a touch of sweat! I'm still nowhere close to my pre-cancer shape, but at least I'm getting in some moderate exercise. Ah, the energy! Actually, when I decided to go on the walk I was so tired that I was contemplating an afternoon nap. But since I needed to drop off something at the post office, and since the dog and I had been cooped up those past few days due to the bad weather, I decided a walk would be better. And indeed it did! I was still tired when we got back, but I nonetheless managed to make dinner. 

Today was thus a pretty productive day for me. Hey, it feels good to be almost normal!!! 

I'm so glad that I feel much stronger and more like myself again. However, I can feel a strange pain in the roots of my hairs (didn't even know those could hurt...go figure!) and gradually I'm shedding more hairs than normal. Of course I'm hyper-vigilant since I know what's supposed to happen, but I swear these must the first stages of my hair coming out.

Interestingly, so far it seems the grey ones fall out first -- whatever that means! So it remains to be seen how much I will feel like myself once the hair is gone. But I'll deal with that once it comes. For right now I'm feeling really good, and almost ready to face another cocktail hour with the "red devil." Let's hope that tomorrow will be at least as good a day!

Sunday, June 14, 2009

Days of Wine and Roses

Well, actually the weekend involved absolutely no wine for myself -- but it did involve lots of roses!!! I've had myself a very nice weekend with DH, just enjoying spending some quality time with each other, puttering around the garden and venturing out. Today, for instance, we went to a local state park which used to be a famous family's mansion. Today, the grounds are a state park open to the admiring public. Sometimes they host special events there, such as a rose exhibition and judging. Given that June is the rose month, and given that I am particularly determined to stop and smell the roses this year, we didn't really have a choice but to go. 

The weather actually cleared up in the afternoon, so after donning sunscreen, protective clothing, and one of the cute hats I got for my soon-to-be-bald days, we ventured out to the park. The rose exhibition actually consisted of only one conference room full of cut rose specimens, but let me tell you, the smell in that conference room was heavenly! We admired many gorgeous cultivars, including my favorite, Scentimental (which won many prizes), but also an old favorite we used to grow at the first apartment DH (who was just my boyfriend at the time) and I ever shared, Blue Girl, a lovely lavender colored rose with a spicy scent. We've been looking for that rose ever since, as we planted that rose where everyone told us it would never grow, and yet it became a stunning bush full of blooms year after year that the neighbors would stop and smell when they walked the dog in the morning. It became the envy of the neighborhood, and here DH and I were just two young folks with no gardening experience, and a lucky hand for roses. So seeing that Blue Girl today was a sweet blast from the past.

After the rose exhibit, we walked all over the park, enjoying the beautiful vistas at ever turn, admiring the many old trees that grow on the beautiful grounds of the park. Why am I so excited about a few hours of walking about and doing stuff? For me this is quite an achievement these days to walk this much, as I am still working on getting back into better shape. Not surprisingly, then, I needed a nap after we got back home...

Overall, though, I feel better than I ever thought possible little more than a week after my first chemo. I am so lucky that I am surrounded by people who love and support me (even if I'm often too scatterbrained to return emails -- sorry,  guys, I'll get around to it!), with my sweet DH feeding me and caring for me as though I were a little baby bird. All I need to do is rest, and focus on letting the good poison do its work of hunting down and taking out any remaining cancer cells in my body, so that I will soon be disgustingly healthy again. After all, we have a bright future ahead of us, and twelve little frosties, our potential future babies, waiting to be thawed out. When that happens, there will be no wine for me, either, but there will be roses for sure, I'm thinking. 

Friday, June 12, 2009

Fighting Song

I haven't posted in a few days, as there was really nothing much new to write about. I've been feeling pretty good, although my energy levels are still low and I don't feel like tackling the many things I should be doing around the house. So I've just been taking it easy, laying low, and pretty much hiding from the world, which felt quite luxurious actually. 

In the meantime, some of the typical chemo side effects have slowly reared their head, though. All of my mucous membranes have started to dry out considerably. My eyes have been so dry that I have had to use a special gel to keep them properly lubricated. My mouth is also starting to get dry and irritated. It just comes with the territory, I suppose. But it reminded me that in less than a week, I am due for another round of chemo.

For some reason, this made me think that I needed a fighting song for my chemo treatments. So here is my first attempt at cancer poetry -- with my apologies to my favorite poet, Emily Dickinson whose work I took the liberty to adapt... 

My Fighting Song for Chemo

My Life had stood - a Loaded Gun -
In Corners - till a Day
The Cancer passed - identified -
And carried My Breast away - 

And now in My Sovereign Body - Cancer may still sneak -
And now I hunt It like Doe -
And every time I speak at It -
My body straight replies -

And do I smile, such poisonous light
Upon the Valley glow -
It is as a Vesuvian face
Had let its pleasure through -

And when at Night - My good Hunt done -
I rest My weary Head -
'Tis better than the Eider-Duck's
Deep Pillow - to have shared -

To this foe of Mine - I'm deadly foe -
It won't stir the second time -
On whom I lay a Reddish Eye -
Or an emphatic Thumb -

Though I than It - will longer live
It longer wants - than I -
For I have but the power to kill,
And It lacks--the power to die--

Tuesday, June 9, 2009

A tale of two doctors

It was the best of times, it was the worst of times... Today was another day of doctor's appointments for me. First I saw my boob man in the morning, and then the butcher in the evening. It was an interesting contrast, not just in the kind of work that they do, but also in the way in which they relate to their patients. So today's entry is going to be a brief tale of two doctors. 

Dr. K, the boob man, met me promptly inbetween surgeries to remove the stitches from my implant revision. When he entered the exam room, he not only smiled, but asked "How are you feeling today?" I told him I was feeling pretty good and that I made it through the first round of chemo while suffering only tolerably mild side effects. He seemed glad to hear it and made polite conversation for a bit, giving off the vibe that he really cared. Then he asked to see my boob to evaluate the healing process. The exam room was set up with a sterile set of scissors and tools, and he proceeded to examine the incision and removed the stitches.

When he spotted the chemo port scar on my right shoulder and noticed a scab and a tad of redness, he looked a bit worried and immediately proceeded to examine that scar, picking out a stitch that was poking through. When I informed him that I would see the butcher later that day, he seemed reassured and said he would leave the other stitch for Dr. R to examine. DH, who accompanied me on my doctors' outings, couldn't help but jokingly remark that Dr. K would probably have managed to squeeze a whole new boob through the incision Dr. R needed for that tiny chemo port. This brought about a broad grin from Dr. K together with a "probably..."

Afterwards Dr. K took some time to answer all my questions about the muscle tightness I have been experiencing in the pecs, and about beginning exercise again. He even went so far as to tell me to not do flyes and bench presses, and to specify how heavy my weights may be. Then he inquired about my next to chemo rounds and asked me to come back for a refill two days before my July 2 poisoning date. Then he bade us goodbye and left.

In contrast, the afternoon appointment with the butcher was a bit different. Dr. R met me promptly right at the assigned time. He greeted me with a handshake, and asked "How are you?" without really waiting for an answer nor waiting to hear one. When I told him I made it through my first round of chemo, his immediate followup question was "Oh, so did the chemo port work?" Granted, I was there for a post-surgical follow-up after the chemo port insertion, but don't you think I would have lead with "That chemo port of yours didn't work" if that had been the case? Anyway, Dr. R never inquired how I did with the chemo or anything.

Then Dr. R immediately proceeded to examine the chemo port scar -- with one single glance while standing high above me. He deemed it fine, told me to come back in four months, and turned to leave. The whole interaction had lasted barely 30 seconds and he was almost gone!

I, however, being inquisitive, had a few questions for Dr. R first. First of all, the chemo port had been bugging me since Dr. R put it exactly where the top of my bra and the straps run. This makes for some uncomfortable chafing at time. Secondly, the scar has scabs (unlike any of my other surgical scars -- which were all done by Dr. K) and still had a few stitches sticking out. So I asked him to remove those, to which Dr. R replied "But they'll dissolve eventually..." Well, eventually isn't good enough for me, so I told him that the thing is in the way of my bra and chafes (which is something I had previously been worried about, asked him about, and been reassured that he had "never received a complaint" -- I complained today, but I doubt he got the message...). Thus forced to take out the stitches, Dr. R headed into the hallway and yelled for a nurse to bring him some scissors, as none were set up in the exam room. When those arrived he took out the remaining stitch. In response to my complaints about the port pulling and being generally in the way of my movement, he said "You know, it's kind of like when you get a cavity filled and at first your tongue thinks there is a new thing there. But you get used to it after a while." That was the entire explanation. He then gave me a reassuring smile, shook my hand while reminding me to reappear in four months, and fled.

It was a really interesting contrast to me. So much about my cancer experience thus far has been an absolute loss of control over what happens to my body. I have been forced to undergo several invasive surgeries that have left indelible marks upon my body. I am in the process of undergoing a therapeutic poison regimen that is putting the aging process within my body on fast forward. In other words, being a cancer patient is much more about the cancer in so many ways than it is about ME, i.e. the human being that these doctors are supposed to be freeing from cancer while leaving it in serviceable enough condition that is as close as possible to my pre-cancer condition.

I felt happy after my visit with Dr. K because he made me feel like he cared about me as a human being. I felt not so happy after my visit with Dr. R because he made me feel like I'm just another cancer case, not an individual human being. Now, I fully understand that doctors cannot and should not get attached to patients in too personal a way. They, too, need distance both for their own sanity, and in order to make the best objective medical decisions. Nonetheless, I think this clinical distance can and should not get in the way of seeing and treating your patients as individual human beings. Therefore I plead to all doctors to always remember: Cancer is something that I have, not something that I AM. So for crying out loud, please make the effort to see me as an individual human being!

Things I am particularly grateful for today: that DH stayed home and accompanied me on my doctors' tour; that I had increasing energy levels and less chemo brain today; that there are wonderful doctors such as Dr. K, Dr. A, and Dr. Z my primary care physician who always look at me as an individual human worthy of their attention and compassion.

Monday, June 8, 2009

Foggybrained

I've been having a slow day. Although I started out with all kinds of ambitions, I didn't get anything much done as I was simply tired and foggy-brained. Despite the fact that I had a pretty good night I just couldn't think clearly today. Chemo brain, anyone? For the first time I felt I had real trouble finding words and such. Oh well , yet another lovely side effect of the treatment. On top of it, I am starting to feel both my mouth and eyes get very dry. Well, at least there is no bone pain worth mentioning so far. Yay!

My computer did not make my life any easier for my foggy brain, either, as the nifty netbook once again failed to boot. For the second time, it had an issue with a driver that prevented it from booting at all and required a rescue re-installation of everything. I spent much of the day trying to understand and execute instructions for making a USB stick bootable, but ultimately I could not figure out everything I needed to. This would have been challenging for me on any good day, but today it turned out to be a day-long struggle.

Despite such issues, I managed to take the doggie for a walk this morning so I can get in some exercise. It's about time I got more serious about getting back into shape. Tonight after dinner, which DH was sweet enough to make (how can a woman not love a good cook?!!), we even went out for another 45 minute walk. Even if my brain was foggy, letting some fresh air blow through it certainly helped!
So I try to do what I can, and I try not to dwell on what I cannot do. There simply is no point to obsessing about it. All I have to remember is to keep on working at getting better and doing more, one day at a time.

Sunday, June 7, 2009

What a beautiful day

It has been a nice and sunny day today, and I have gotten to enjoy quite a bit of it. After a leisurely breakfast, DH and I grabbed the doggie and took him for a nice long walk in the shaded woods. It was my longest post-chemo walk so far, and it was absolutely delightful! It feels so good to finally get moving again. So you keep your fingers crossed that my various surgeons will clear me for more than just walking when I see both of them on Tuesday.

I had been a bit apprehensive about today since I am offically out of anti-nausea meds from the study, with only the rescue meds left. Those, however, can come with a host of complications from what I read (maybe I shouldnt' surf the internet as much as I do???). But my fears were unfounded, as I didn't have any problems with nausea. The trick really seems to be to have lots of little meals spread out throughout the day.

Other than that, I puttered around the garden some, finally made the house just a tad more tidy than it's been (ok, I'll admit, it's still a mess -- but at least a mess in progress!). For the rest of it, I simply took it easy and made sure to rest a lot. So it's been a really beautiful day all around.

To top things off, I just heard from 2l that her dad made it through emergency surgery alright and is now recovering at home. That is excellent news!!!

Saturday, June 6, 2009

One of those nights...

Last night wasn't so good, as the nausea hit me quite hard. Maybe it was the Indian food (small sins apparently get punished post haste...), maybe it was the Neulasta shot, maybe it was the delayed nausea that study is looking at, but in case it was nausea alright. It seems that at night, those stomach acids are always churning more than they should. So I woke up around 2 a.m. with a serious case of nausea, and couldn't get any sleep until 6 a.m. Crackers didn't help; sitting up in bed didn't help, so around 4:30 a.m. I was finally smart enough to remember I had another weapon in my nausea arsenal. So I took my "rescue medication" Reglan, which took a while to help, but eventually did the trick and bought me another hour or two of sleep between roughly 6 and 7 a.m. The sleep total for the night ended up somewhere around three of four hours then. One of those nights -- I'd actually like to sleep through the night!!!

Well, this way I got to catch up with the entire first season of Weeds, as well as part of the second. At least that was an entertaining way to spend the sleepless, acid-churning hours. Thanks to my friends who gave me that Netflix subscription. I love it -- and in particular the streaming videos that allow me to satisfy my entertainment needs on an instantaneous whim.

It turned out that the morning brought another side effect of the medications, though, probably from the Neulasta shot. For a few hours this morning, my face was flushed red. Oddly, this looked quite healthier on me than my typical post-too-many-surgeries pale glow... By noon, however, my face was no longer warm nor red, and my chemo pale look had returned.

Surprisingly, the not-so-good night was followed by a really good day. With regular anti-nausea meds and frequent but small meals, my stomach was much more cooperative than during the night. It seems the secret is to keep something in my stomach at all times, which may mean that I need to eat more during the night? Well, I hope I'll figure out this whole nausea thing one way or another. 

My energy was pretty good today. I went for a brief walk with the dog around noon today, and a longer one after dinner. In addition, DH and I went shopping for a number of different things we needed/wanted, including a wig! This way I won't have to scare little children with my bald pate once the hair is gone (which will supposedly be on its way out in approximately a week and half). 

Tonight after dinner I even had the energy to do the dishes and clean the counters, and then go for a bit longer walk with the dog. And all that after we had spent the entire afternoon out shopping. So my energy level is definitely better today than it has been. Even if there are temporary setbacks, I seem to be on an upswing overall. 

I am really happy that so far, everything has been tolerable. It is definitely no walk in the park, but given the scale of things, I had expected to do much worse than I have. So let's hope that this trend will continue, that I will be able to exercise more and get stronger so my body can evict that nasty TNBC for once and all.

Friday, June 5, 2009

Still not half bad!

The first post-chemo day luckily brought only very light nausea which was no worse than yesterday. Looks like I'll be one of the lucky gals that might get away with little discomfort that way. Yay! Other than that, I've only had a few brief episodes of fast heartbeat which the nurse thought might have come from the steroid they gave me yesterday. Tonight, though, I even felt well enough to have dinner at a Dosa place on our way home from the doctor's appointment tonight. How daring is that? Indian food the day after having chemo?!! Overall, this is not half bad for what I feared chemo might feel like...

Yes, I know my hair will fall out over the next two weeks or so. Yes, I know that I might still get bone pain from the Neulasta shot they gave me today. Yes, my white blood cell count is bound to get worse with each round of chemo. Yes, I may still develop other complications. But so far I am simply very happy that I have made it through my first chemo round so well.

One round down, seven rounds to go!!! This morning, I lit my first chemenorah candle to celebrate the occasion. It is a very good feeling to see the little candle burn in commemoration of my first chemical round against cancer. In a few months, there will be a veritable sea of lights signifying the end of these chemical battles with TNBC.

Then I will have to make a decision over whether or not to have myself fried, too, i.e. irradiated. It's not a clearcut case, as the little extant literature is based upon old data from a time when they used a type of chemo on TNBC girls that was much less effective than the current anthracyline and taxol based regimens, and particularly dose-dense ones. Based upon old chemo courses, radiation treatment benefited TNBC girls with an additional 3 percentage point survival advantage. However, given the better chemo treatments, this may no longer be true. Plus, radiation can cause problems for my reconstruction, can affect surrounding skin, can cause cancer in the other breast... and will lead not only to  5 1/2 more weeks of treatments (daily ones at that), but also to more fatigue and other side effects. If I had confidence about the 3 percentage point survival advantage, I'd go through the trouble. But it is not at all clear that I would be able to expect an equivalent advantage from this treatment. So more stuff to think about...

On a different note, 2l's dad was supposed to have surgery on his malfunctioning defibrillator to replace the shorted out leads. I hope that everything went well and that your entire family will get to breathe a deep sigh of relief as he begins his road to recovery from his recent heart issues. We have been thinking of you all and sending lots of supportive and healing thoughts your way!!!

Thursday, June 4, 2009

So far, so good

I can feel the queasyness starting to build in my stomach, but so far the meds are keeping it at bay. We had dinner and I was ok. I am reallly surprised by how well I have tolerated my poison cocktail so far and hope that my luck continues. It seems a bit weird that the doctors cannot really predict who will react how to the meds as the reactions are too individual. Every body is different, and every body has a different way in which it processed the drugs. They're pretty potent stuff, but so far my body seems to be tolerating the chemical onslaught pretty well, for which I am very grateful. 

I have been warned, however, that the nausea may well be delayed and kick in tomorrow, when the drugs they pumped into me today have worn off. They do have meds for that, but since I'm a geek I couldn't resist taking part in two research trials, one for the delayed nausea, and one for the bone pain I might get from the Neulasta shot I will receive tomorrow that will boost my white blood cell count so I will actually survive this chemo.

Don't worry, I won't be getting any new and dangerous drugs. These trials are about established drugs that they give in new combinations, or for a new purpose. For one of them (bone pain,which apparently afflicts more than 60% of patients after the Neulasta), I may be receiving a placebo. In both studies, however, I am allowed to take "resuce medications," i.e. meds that fight the symptoms in case the experimental meds/dosages weren't enough. So I should be both safe and as symptom-free as modern pharmaceutics will be able to keep me.

These studies involve a bevy of questionnaires I need to fill out. The research nurse came and explained everything to me, which ended up taking up most of my actual chemo treatment. As a consequence, time almost flew by once we were in the treatment room. I didn't have time to watch Netflix, or surf much, or play the little paper Trivial Pursuit game my friends gave me (those are cool -- thanks so much!!! Actually, it just occurred to me that I didn't light my first chemenorah candle either... it's late now though, so I'll have to do that tomorrow to celebrate! Sorry...

It really wasn't that bad of a treatment. The nurse was very nice, the stick didn't hurt too badly, no allergic reactions, and the nausea isn't too bad so far. I even had the energy to go for a nice walk with DH and the dog . I'm a very happy camper.

As the poison courses through my veins, I imagine that it is killing all the cancer cells that are hiding within my body. It may be poison they're giving me, but the poison is my friend!

My very first cocktail hour!

Thanks to the marvels of modern technology, I am writing this as I am sitting in my chemo recliner in the treatment room. There is wireless internet access here (although the system doesn't allow me to access blogger directly, I am hoping the email version works) and so I am connected not just to the tube that drips poison into my body, but also to the world outside. 

I don't want to jinx myself, but so far, the waiting has been the worst part of it all. We arrived at the Cancer Center at 1:45 p.m. for my 2 p.m. appointment, and it was almost 3:30 p.m. by the time they finally brought me back to the treatment room. My finger stick for the CBC was almost immediate (I'm so dissappointed they can't use the port for that!!!), but then there is always a wait until they've analyzed the blood to make sure I'm in good enough shape to take the chemo. But this wait was much longer than I had anticipated.

In any case, the nurse was VERY happy that I have a chemo port, as it makes both of our lives considerably easier. She got me in one stick, and started giving me saline, then steroids and anti-nausea stuff. Then, finally, my first meeting with Adriamycin (aka the "Red Devil"). It really IS red, and it comes in big fat syringes. The nurse just pushed it in over a few minutes, told me to chew on ice to protect my mucous membranes, and it went just fine. Then came the Cytoxan, which is a drip that goes in over 30 minutes. Then some more saline to flush, and a bit of heparin to keep the line free of clots. No big deal so far. Everything went smoothly -- no allergic reactions, no nothing. Now it's just a question of waiting to see whether I develop any side effects. It's almost 6 p.m. now, and the needle is out and I'm ready to go home. So I'll get this posted and then we'll see what hangover I develop from my first cocktail hour at the cancer center...

Wednesday, June 3, 2009

Almost there...

So tomorrow is the big day when they are supposed to put my mediport to its first use. It's healed in quite nicely overall, and the scar isn't as thick and scary as it first was. So watch out chemo, here I come. 

Overall, I felt better today and less sick, which is a good thing given that they'll poison me tomorrow. DH is taking the day off to accompany me to my first "cocktail hour." The particular cocktail my poison man has ordered for me tomorrow consists of AC, i.e. the chemotherapy drugs Adriamycin and and Cytoxan. The former, which apparently is bright red, may damage my heart, which is why it is sometimes nicknamed the "red devil," while the latter is going to make my hair fall out, probably within the next two weeks. Both will make me nauseous and do other funky stuff to me, which I'll be delicate enough not to mention. The advantages, however, of these potent poisons are that they attack rapidly dividing cells, such as the TNBC cells that may still be floating about my body. Adriamycin is going to kill them by preventing cells from making or repairing their DNA, while the latter will keep cells from replicating. I very much like the idea of killing the cancer within. This is a battle after all, and one that I plan to win. So you go get those nasty little cancer cells my poisonous friends!!!

I am a little sad that my mom will not be here with me when they first poison my cancer within. But she had to fly back home today. We took her to the airport tonight. But after three months, she really needed to go back. So now it's just DH, me, and the dog again. Almost like in the olden days... just a bit sicker. But that, too, shall pass!

Tuesday, June 2, 2009

Are we there yet?

My slow recovery continues. I keep getting the weirdest sensations, which either caused by the chemo port, or by the strange worries in my head. I woke up bathed in sweat several times last night because I couldn't breathe properly. The surgeries force me to sleep on my back for most of the time (and I'm normally a side sleeper) and between the drugs, my allergies (which are acting up right now like nobody's business), and my paranoia, I seem to have developed some sleep apnea. With more allergy meds in me today, I'm hoping the night will be more restful, though. 

Still, I keep feeling weird, kinda out of it, even though I've weaned myself off the vicodin. I should also have the anesthesia out of my system by now. And still, I have episodes of feeling lightheaded and weird, and the odd sensation that my pupils are dilating at different speeds in the left and right eye. When I went to the grocery store today and tried picking a can off a low shelf, I got dizzy and lightheaded and felt as though there was too much blood rushing to my head.On top of it, a bunch of veins in my hand are nice, painful, and thrombotic by now, making me wonder what the chemo port is doing to my subclavian vein. So the short of the story is, it's probably all in my head...and I'm just making a slow recovery from that last round of surgeries.

So I remind myself: those thrombi will dissolve eventually with no ill long-term effects; that chemo port will work just fine, delivering dangerous drugs efficiently and safely; these weird sensations are really just recovery pains that will dissipate soon enough. Are we there yet? Not quite, but I'll get there eventually. Tomorrow is another day...

Monday, June 1, 2009

Despite the fog of anesthesia

I must be getting old or something, but it seems I just don't shake off anesthesia like I used to... I say with all of my two and half months' worth of experience with such things... It's been another slow day for me, as I am still trying to dispel the fog caused by all of those drugs that my favorite sleep man used to put me out of my misery while Dr. K "revised" his previous work. I've never had lingering effects of the procedure this long after the surgery before, but this may well be due to the double whammy I put my poor body through last week. 

So it was another day of taking it slow. The day's main entertainment consisted of trip to my boob man's office for my first post-surgical appointment with him. He was quite happy and pronounced the revised work "perfect." So I am ecstatic that I not only get to shower again (sponge baths only take a girl so far...), but that I also get to ditch the "sexy" surgical bra they fixed me up with. That thing is so huge, uncomfortable, and it sticks out from whatever you wear above it that I just couldn't wait to ditch it. Ah, soft and non-pinching undergarments... I so enjoy the little luxuries in life these days! Going through illness and surgeries like this sure has taught me valuable lessons about being grateful for the little things in life and not to take them for granted.

The next few days will be devoted to further recovery so I will be ready for my first round of chemo on Thursday, and to helping my mom prepare for her departure on Wednesday. I just hope that her flight will be safer than that of the unfortunate Air France flight from Rio to Paris that was lost today. My hearts go out to the families of the people that perished in that horrible accident. 

In a way I am very lucky that all I have is an illness. At least I have a chance to fight this, and to win the war against this cancer. Battles are never easy, but it is the promise of victory that makes them worthwhile. Based upon the few bits of information we have at this point, the poor people on the Air France flight, however, never really had a fighting chance to win their battle. What a tragedy that so many lives were extinguished so cruelly. I cannot even begin to fathom the pain these families must feel. 

But even through my fog of anesthesia I can see quite clearly that I am lucky indeed because I have been given a fighting chance -- yet another thing to for which I am grateful.