Round 1, Day 11: Chemo-condriac?

Friday, after calling Dr. McGrail's office for probably the sixth time in six days, the nurse suggested I come in to see the doctor, what with the long weekend coming up and all.

Dr. McGrail was wonderfully patient and took the time to discuss all of my nagging side effects. As I wondered, am I a chemo-condriac? Apparently chemotherapy has a lot of side effects. But nothing is going dreadfully wrong. Sore throat and mouth sores - use magic mouthwash. Stomach pain - more fiber. The chemotherapy is killing the cells lining my digestive tract, including my mouth and throat, which explains all that. My itchy rash near neck incision - not a freak allergic reaction to the port or chemotherapy; just a simple skin sensitivity to the tape. Doctor's orders - keep exercising to help combat fatigue and anxiety.

Today went to a "Yoga for Women Cancer Survivors" class. The teacher and class participants were very welcoming and the instructor made all of the exercises doable. Definitely want to go back!

Spending much of the weekend catching up on work project - feels good to finally get a little productive.

Round 1, Day 8: Back to work!

Although I am not destined to be one of those superwomen who makes it through chemo without missing a day's work, I am nonetheless very happy to have finally made it back into the office today. Tired after a (3/4) full day's work, but felt really good to get back into my routine. And I cannot ask for a more supportive group of people with whom to work...they are creating me my own "zen" room -- with a couch for napping, and other comforts to make my work day as easy as possible.

Sore throat feeling a lot better. Magic mouthwash has done its magic. Appetite coming back to normal. Now if it would only stop being 90 degrees!

Round 1, Day 5: Ugh

Day 5 kicked my ass. Felt a sore throat coming on as I was trying to get to sleep sunday night, which got worse and worse, and kept me up much of the night. Felt lousy yesterday. All of my strength seemed to go out the window with worry about being sick.

Doing a little better today; got a prescription for a "magic mouthwash," which tastes incredibly disgusting (swish & swallow) but is quite effective. Lots of rest today. Grateful for the emails and notes and calls.

Round 1: Day 4

Had company for the first time last night - yay! Progressive rummy & peruvian chicken were both awesome!

Tired, but walked an hour yesterday and another hour today.

That's it for now -- back to LOST!

Flashback: Biopsy

February 26, had my mammogram at georgetown. And sonogram. They saw a spot, or a speck, and told me to come back for a biopsy. My first biopsy ever.

Biopsy was on March 3. Ultrasound-guided, needle core biopsy. Very strange experience. Hurt more than I expected. Results to come by early following week.

In the meantime, lots of hiking in Rock Creek Park. And planning for vacation in West Palm Beach.

Rock Creek Park, 2/21/10

Rock Creek Park, 3/6/10

Round 1, Day 2: Whew!

Yesterday was a LONG day. Got to Dr. McGrail's office at 10:30, and didn't get finished until 6 p.m. Took a while to go through questions with the doctor, get the additional anti-nausea pre-med cleared through insurance, and go through everything in detail with the nurse. Nurse Karen was awesome. First is the blood draw to check all my levels. Then, the various pre-meds: Aloxi (anti-nausea), Ativan (anti-anxiety/anti-nausea), Decadron (steroid), Benadryl (antihistimine), Emend (the extra anti-nausea med). And then the three meds - taxotere first (90 min), carboplatin (45 min), and herceptin (90 min, for this first visit only; subsequent visits will be 30 min). Inbetween meds, flush with saline. All of this is done through my brand spankin' new port. Nurse Karen sprayed it with cold numbing spray first, so only moderate pain (took three sticks though to get started).

They sent me home with various prescriptions - a regimen of anti-nausea meds: Emend for two days, Zofran for three, and compazine for break-through nausea. Plus the Decadron (the steroid and benedryl help prevent allergic reaction which can sometimes occur with the taxotere).

A tiring day.

Today, went for a slow, 2 mile walk - very nice. Had a refloxology appointment (my research showed that reflexology, as well as acupunture, can help with the side effects of chemo). Appointment is very relaxing too. Then, back to Dr. McGrail's office for my shot of neulasta - to help boost my white blood cell count over the next three weeks.

Feeling pretty worn out now, but managing ok. Which is actually pretty great considering how terrified I've been about this.

But one day at a time. 125 more days to go.

In the chemo room

Here I am in the chemo room, pumped with all kinds of happy pre-meds, and done with my first med, taxotere, and starting on my second, carboplatin. So far, it is remarkably unremarkable. Thank goodness for that. Side effects likely to hit after several days.

A special day -- there have been FOUR chemo-graduates today. Lots of applause. Can't wait for my turn!

Nurses here are wonderful. As is my doctor, who indulged me and let me get the extra anti-nausea med (once clearing it with my insurance company) as a precautionary measure. To be continued...

Erev Chemo

As in, the eve before Chemo #1. (the jews will get this one.)

Here's hoping that an unholy combination of zen, xanax & zantac will see me through (thanks, lisa for the inspiration on that one).

Along with memories of triple chocolate cake, chocolate chip pie, and homemade whipped creme (yes, turns out it can be done by blender!).

18 weeks and 1 day to go.

Pain in the neck

Sitting here, chilling out on the couch, recovering from port implantation yesterday.

Up at 6 a.m. yesterday for early morning appointment to have medi-port implanted in me. What is a port? Here's a good explanation (always handy to save the promotional literature from chemo class) from Portadvantage.

The most difficult part of yesterday's procedure was my own anxiety.

The nurses in the interventional radiology department at georgetown were incredibly kind and patient, they listened well and were very responsive. I cannot say enough good things about them. I told them I was really worried about the part about being put out, after the bad anesthesia experience. Nurse Alice said if I wanted, I could have very light sedation and stay awake during the procedure -- which I did! The doctor walked through me every step. The worst pain was the two numbing injections. One in the neck (where the catheter part of the port went, I think) and one in my chest, about 3 inches below my collarbone. After the injections, about 2-3 seconds of burning pain, then not so bad. The procedure lasted about 30 minutes, during which I was awake the whole time -- yay! The doctor said most of his patients are asleep. Not me. I waited until the 2 hours of recovery time to sleep!

Yesterday and this morning the pain was pretty uncomfortable, primarily the incision in the neck. Finally this evening, I can turn my head without too much pain. Get to remove the dressing and take a shower tonight :-)

Getting ready

Getting ready for the beginning of treatments. Here's the scoop:

Monday I get my port put in at georgetown by "interventional radiology." The port is about the size of four quarters stacked up, and it is installed beneath the skin somewhere below the collar bone. It makes giving the chemo treatments easier and is recommended because I will need chemo treatments 6 times and Herceptin (also as an infusion) another 18 times over the course of the next year. Twilight sedation only so hoping it is not as disastrous as the surgery anesthesia experience was.

Thursday I begin chemo treatments at Dr. McGrail's office in Chevy Chase. Mom is very excited that Meiwah and Panera are right next door!

First will be the blood work to make sure all levels are good to go. Then pre-meds, anti-nausea, steroids for nausea and allergic reaction and fluid retention/swelling, and probably lots more. Then the chemo drugs:

Taxotere (docetaxel), Carboplatin, and of course the Herceptin. First day should take about 5 hours, including some Q&A.

Most of the time (except maybe the first treatment, not sure) I have to go back the following day for a shot of neulasta, to help with my white blood cell count which gets destroyed by the chemo drugs, making me vulnerable to infection. (Time to buy stock in Purell!)

Then -- wait three weeks and repeat. Six times.

Lots of dread and anxiety of course. To do list:

- walking, and lots of it. Dr. M says women who gain more than ten pounds during chemo have higher risk of recurrence. Yikes.

- very gentle yoga

- meditation

- acupuncture

- reflexology

- rewatch the entire series of Lost

- update blog.

Amazing women

I've now spoken with so many women who have been through chemotherapy for breast cancer. But until the other day, none that had done the regimen I was leaning towards, TCH, or taxotere, carboplatin, herceptin. Last wednesday, I went to a support group at georgetown and after telling of my anxieties about chemo and the difficult decision, one of the women told me she knew someone that was doing TCH. Four days later, she emailed me the contact info, and the next day, I spent half an hour talking with a complete stranger about her experience with TCH.

And on saturday, while wig shopping (oy! a story for another day) with one of my breast cancer mentors, she ran into a friend of hers who also went through chemo recently. Also her2 positive. The friend, like everyone else, did the AC-TH regimen. But told me she knew someone that had done TCH. A few days later, the friend called me not only to pass on the contact info, but to tell me that I could call her ANYTIME if I needed someone who had been through this to talk to. Last night, I spoke with the friend of the friend of the mentor -- and while juggling a sick 9 year old, she talked me through her experience with TCH.

Not to mention the mentors. The program is called "Survivors Offering Support," and the founder is simply an amazing lady who, after going through the experience of breast cancer on her own, decided she wanted to make sure others didn't have to do it alone. The program now runs in around ten hospitals and, thankfully for me, started in georgetown a few years ago.

I guess one of the silver linings of breast cancer is discovering the incredible generosity of women who just want to make someone else's experience a little less difficult than their own. All I can say is wow.

Flashback: Snowy February

In August 2009, my gynecologist recommended that I see a breast specialist, given my family history (mother's mother had breast cancer when she was 46). After several false starts, ended up with an appointment at Georgetown with one of the nurse/breast specialists on February 1. Nothing remarkable in exam. Because it had been 12 months since my last screening mammogram, she recommended I schedule one. This appointment was scheduled for February 12, which I canceled because my car was snowed in from snowmageddon (blizzard #2) and then from snoverkill (blizzard #3) -- four snow days in a row! And I didn't think it was a big deal to reschedule. Rescheduled for February 26.

Picture: Kalorama Road, February 10, 2010

Decisions, decisions.

Follow-up appointment tomorrow with oncologist at georgetown, and chemo orientation. Then need to make final decision -- which chemo regimen (AC-TH, or TCH) and where my chemo home will be, at georgetown's "5-North" or at Dr. McGrail's welcoming office in chevy chase.