No more AC!!!

Well, it's done, over with, finito. I am officially done with my fourth and final round of the AC part of my chemotherapy! The port worked just fine. Now I 'just' need to ride out the aftereffects of this last poisoning and I'll be ready to move on to Taxol. Yipee! This means that I am essentially halfway done. Sort of like being on top of the mountain, looking down, knowing that it's all downhill from there -- but in a good sort of way. As soon as I feel up to it, I'll have to have a little party, even if it's just DH and me. But I have a feeling it'll be a week or so before I'm up to it. 

I was so tired today as I didn't sleep well last night. I never really fully woke up until they gave me the decadron. Now I'm still tired of course, but also wired because I'm full of steroids. The nurse said that the day before the first Taxol treatment I'll need to take FIVE decadrons (right now they give me three the day of the treatment). I cannot even imagine how wired I'll be on those...

The main thing is that this particular part of my chemo journey is almost over. I won't call it over entirely until I'm done dealing with the side effects of all the lovely chemicals they pushed into my body today. Oh, did I mention that they will need to do a full chem panel before each Taxol treatment? Today, the nurse drew the blood for that through my port during my regular treatment. But normally, they don't do that as blood values change too much after treatment. So I'll need to make an extra trip in to have blood drawn before each chemo. Given the thrombosis in my 'good' arm and the generally deplorable state of my veins, however, I will need to make sure that the chemo nurses draw the blood by accessing my port. They will need quite a bit, and I doubt my veins would yield as much, even if successfully poked. Ah, each type of poisoning has its own challenges...

Well, I'm tired, so this is my entry for today. I think I'll spend the rest of the evening just lounging and watching Netflix or doing some similarly mindless things. Chemo makes me kind of foggy, so I'm really no good for more than mindless things. Well, maybe I'll manage to pet the doggie on the side if he's lucky. Come to think of it, this, too, would probably fall into the category of mindless activities. So I'll resign myself to mindless activities to pass the time, and hope that the medications will manage to keep the nausea at bay without upsetting my GI system too much.

Clearing the Port

I went to have my dye study of the chemo port this morning. The procedure was quick and painless, and I am happy to report that the doctors found absolutely nothing wrong with my chemo port. It works beautifully and is positioned perfectly. This means that provided my CBC checks out tomorrow, I should be able to receive my fourth AC chemo treatment as scheduled tomorrow. Yay!!!

When the nurse knows what she is doing, accessing the port really doesn't hurt me that much. When nurse L accessed it, it was always that way, too. But during my last round of chemo, I had nurse A -- who was not that good, I am afraid. Not only did she claim that the port "moved" on her, but it really hurt when she accessed it. After that, she put the protective clear covering on so weirdly that it tugged on my skin in the most uncomfortable way. I had to ask her to redo it before I could bear it. But as nurse P at the hospital proved today, it doesn't have to be like that. I noticed, though, that both nurses L and P used two fingers to stabilize the port while accessing it. I believe that nurse A failed to do that. So I'll have to remember to make sure that nurses always do that. It's sad I have to check on new nurses that way, but it is in my own best interest...

Another thing I learned today is that I should not allow anyone to take my blood pressure on ANY of my arms right now, including the right arm that is normally my "good" one. The thrombosis is low enough on the arm that the constrictions from the blood pressure cuff gets uncomfortable really fast. When I noticed the discomfort, nurse P acted quickly and got it off, which was good since my arm was turning quite blue. Instead, she offered to put it on my leg. That was a marvelous idea I gladly accepted. So from hence on and until the DVT has cleared, I'll insist on having my blood pressure taken on my legs. I learn something new just about every day...

What else has happened since I last posted? Oh, that's right, on Tuesday afternoon I went for another topping off session with the boob man. After he added another 50 ml to my foob I really started to feel the stretch. Given that I am now on lovenox to thin my blood and given that I really bruise easily now, we decided that 50 ml was enough for the day. Today I am particularly glad for it, as I can still feel the stretch of that little bit of extra fluid pushing against my muscle and skin. 

So I had two doctor's visits in two days, and both were successful. That's nice. Two more visits tomorrow and Friday for chemo and the Neulasta shot, and I'll be done with HALF of my chemo. Yay, yay, and yay. Can't wait to leave the red devil and his sidekick cytoxan behind me. After that, it'll be on to Taxol and whatever 'joys' that may bring. But first I have to make it through my last round of AC. 

Since even the thought of ice cream, which I've been using to cool my mouth during the administration of adriamycin, even the thought of ice cream makes me nauseous. So this time I'll have to try something new. The best I can think of is to take some strawberries and peaches and freeze them so I can suck on those as they push the red devil in. We'll see how that goes. But for right now I am just very relieved that I can go ahead with chemo tomorrow. I'll try to post again from the treatment room, just because it is so much fun...

Can you say UEDVT???

A few weeks ago I had a conversation with my poison man that went something like this:

"Are there different types of mediports, say some that are less prone to produce blood clots? Because you know, Dr. V, that I have had so many issues with thrombophlebitis whenever they put anything into my veins..."

"No, they're all the same. Blood clots or thromboses really aren't a big issues with mediports. We hardly ever see them."

"But what if I get them??? I'm pretty worried that I will."

"Don't worry, if you get them we'll just treat them."

Fast forward approximately two months to last week. I have had a harder time with the third round of chemo as it has upset my digestive system. On top of it all, I started to develop a strange pain in my right arm on Thursday. I had trouble lifting things, as any exertion caused me pain. As I looked at it and compared it to my left arm, I also noticed that the right one was sort of grayer and more splotchy looking than the left one. So I waited until DH came home and asked him to compare the color of my arms, just to be sure I wasn't hallucinating. He agreed there was a noticeable difference. Phew, at least it's not all in my mind...

On Friday morning, I didn't feel so hot at all (well, at least I didn't have a fever...). Since I wanted to call the oncology nurse anyway because of my continued GI issues, I also mentioned the pain in the arm to the secretary that takes the messages and passes them on to the nurses or doctor. Well, I never even got to talk to the nurse, as based upon my message, the secretary called back and told me that I need to come in ASAP to have my veins scanned "just to reassure me and make sure I don't have any clots in them." Of course that made me really worried.

I didn't feel well enough to drive, but DH had needed to make a quick trip to work and was still on his way back. So I got myself ready and awaited his return so we could hurry out to the Cancer Center. An hour later we got there and checked in -- except they couldn't find the prescription my doctor's office had supposedly faxed over. Lovely. Half an hour later, that issue was sorted out, and we began what ended up being a two hour plus wait. They had a full schedule, and we were an "add on" which meant that we needed to wait to be squeezed in. I didn't really mind that much, although the wait was not all that comfortable. But I was just glad that they could squeeze me in. An elderly gentleman who had waited two hours when we got there, however, was not as patient. Maybe his complaints explain why the manager ended up taking me back while apologizing profusely. 

In any case, the doppler ultrasound vein scan itself was an experience. Thank goodness it's noninvasive and does not involve any needle sticks. But even though the technician did not have to use needles, she had trouble finding my veins! Now that explains a thing or two about why the people with the needles always have such a hard time... The scan began at the jugular vein, which thankfully was clear. As the tech got to the subclavian, however, she started taking lots of pictures and mumbling something about "you might have a tiny clot in there..." Oh great. And as she went scanning down my arm, she stopped talking to me altogether and snapping lots of pictures instead. I figured that wasn't a good sign. So it turns out that I have some pretty massive deep vein thrombosis in the upper arm, more specifially in the subclavian, axillary, and brachial veins. In the world of medical acronyms, this is known as UEDVT, or "upper extremity deep vein thrombosis." Supposedly, these are not as likely as their lower extremity counterparts to lead to the dreaded pulmonary embolism that can be fatal, but according to at least one study I found, it is quite common in patients with UEDVT.

Ugh, this is not good. I wasn't exactly itching to get another complication. But I suppose things were just going to well to be true. My doctor decided to put me on low molecular wait Heparin to prevent further thrombus formation. This means that for the next two weeks I need to give myself two daily heparin injections, and then only once daily heparin injections for a "few months" after that. Now, I don't normally mind subcutaneous injections into my belly that much. I did plenty of them during our fertility preservation IVF cycle. However, these heparin shots HURT -- much more so than anything else I have had to inject myself with before. Plus, the frequent injections -- with a blood thinner!) are starting to give me lots of tiny bruises on my stomach. Yikes. I'm supposed to be doing this for how long???

This weekend thus brought lots of rest for me, some distractions, as well as time to process Friday's diagnosis. On Saturday I got some welcome distraction when we doggie-sat Mr. Shnubbins for a few hours. On Sunday, DH took me to the movies and then out shopping for a new pair of earrings. All of this was nice, but unfortunately my arm still hurts. Actually, it seems to be getting worse and traveling down my arm, now also affecting my ring and little finger. This isn't funny any more. I guess tomorrow I'll need to make yet another call to the oncology nurse.

On Wednesday morning the fun continues as I go for a chemo port dye study to make sure that my port still functions in the first place. If it doesn't, I'm in trouble for my next round of chemo, currently scheduled for Thursday. But it just doesn't sound like a good idea to put those caustic chemo meds into some other vein in my arm given that the veins are irritated by the DVT already. So if my port no longer works, those doctors had better figure out something quickly...

Keep your fingers crossed for me...

Balancing act

I suppose life is always a balancing act, but life during chemo requires even more balancing than life normally does. As I am finding out, during chemo even the simple act of eating may require considerable balancing. Although I had been doing better for the past day or two, today my digestive system started acting up again. This time I'm not even sure why. I hadn't taken any more medications, things had settled down, so I thought I was home free for this round. But noooooo, of course not. It started all over again. Ugh. So this time I am trying to be better and not eat bland foods plus a modicum of stuff I actually have an appetite for, but just bland foods until I'm reasonably sure things are back to 'normal' -- whatever that may be these days.

Still, overall I am feeling better than I did yesterday. Not even a nasty thunderstorm front that barrelled through our area overnight could change that. It was so nasty and so close that the first flash and thunder that woke me from a fitful sleep at midnight came almost instantaneously. Honestly, I thought the lightening had struck the house across the street where our elderly (and unfortunately also increasingly demented -- it's heartbreaking) neighbor lives. Luckily, it just sounded as thought lightening struck, but the storm was fierce and accompanied both by copious amounts of rain (2.3 inches according to our rain gauge), and judging from the noise also by hail. The dog got quite apprehensive, the poor thing, and couldn't understand why I wasn't worried. I did get up to close the windows, but otherwise the storm bothered me little. I even fell back asleep before it was all over -- and all without Ativan or other chemical helpers!

In a way, I think I have my cancer diagnosis to thank for that. I used to have lots of trouble sleeping, as my overactive mind worried about all sort of things: professional issues, personal issues, health issues. Oddly, however, since my diagnosis I have generally slept much better than I have in years (with the exception of those sleepless nights thanks to decadron, of course). Once some of my worst fears had come true, there didn't seem to be much of a point to worrying about most things. It is strangely freeing, but for a girl with cancer I believe I worry remarkably little. More so than anything, I have once again learned to simply be, to just exist. It is what helps me deal with the sad fact that at this time when I was supposed to be happy and pregnant I am instead fighting chemo-induced nausea and other health issues. So I have learned to find a healthier balance between the now and the future. I am grateful for that -- because at least for right now, I get to live.

Like clockwork

It's Tuesday, and right on schedule I am starting to feel better. Even if the severity of symptoms isn't that predictable, it appears that the timing is fairly foreseeable. Although I can feel that this last round took a greater toll on me than previous ones, both my nausea and my spirits are starting to improve. 

This morning I was so tired that I could have kept sleeping. But I willed myself to get up and take out the dog. I felt very weak, but it was good to be out walking. In order to keep from falling asleep, I spent the morning watching documentaries on Netflix, but by 11 I was so tired that I decided it was time for a little nap. Well, my "nap" ended up lasting three whole hours, but I awoke refreshed, albeit with the Neulasta pain starting to affect my joints and bones. It's not bad -- just enough to make me feel old and arthritic. Maybe I'll take some Alleve for it tomorrow, but for today I did not want to stress out my stomach with medications. Actually, I am starting to get thoroughly tired of pills and other medications, as they seem to be the ones that keep getting me into trouble. Seems I'm always trying to balance one side effect against another. 

So for right now, I have sworn off the pills (at least until the next round of chemo, or until the bone pain gets to be too annoying  -- whichever comes first) and rededicated myself to more walking. This evening, DH, the doggie and I went on another walk together. It wasn't the longest walk we've taken, but since I still feel a bit more fragile than usual I didn't want to overdo it. And after all, every little bit counts. 

Since I had napped enough in the daytime, I even managed to find the energy to make dinner tonight. At times, the smell bothered me, but when it all done I liked it well enough that I ate way more than I thought I could. Yet another small victory. DH and I ended the day with a movie night, enjoying a film we'd been meaning to catch at the theater but never did. For my limited ambition these days, I would certainly call today a success.

Ah, getting better is such a good feeling! I even laid down in the back yard today just to watch the clouds drift by for a while. I am really enjoying stealing little moments like that and just being again, rather than feeling miserable. If on top of it all, I can get a good night's rest out of this day as well, then I will be a very happy camper...