Chemo day

Hers and His almost bald heads

I came back from chemo around 4:30.  Not feeling my best, feeling kinda “blah” actually.  Feeling queasy & I’ve been having back spasms, though I’m not sure if the spasms have anything to do with the chemo (nor does the doctor).  I just know that the taxotere seems to magnify any ache or pain that I already have, so my messed up back aches more during and right after chemo.

Here’s how a typical chemo appointment goes.  I arrive at the medical facility, check in, pay my insurance co-payment, then sit and wait.  I am called into an examining room where a nurse checks my temperature, blood pressure and my weight. Contrary to popular belief, most people gain weight on chemo-partly due to the steroids given beforehand, and partly due to the fact that chemo can tire you out, so workouts aren’t as strenuous or long as pre-chemo. Your temperature is checked because had I been running a fever, chemo would be a NO-GO.  No chemo if there is a possibility that I had some sort of infection.  Chemotherapy wrecks havoc with all fast growing cells, including blood cells (& white cells, platelets, etc, stave off infections & If your counts are low, the docs don’t want them going any lower).  Then I wait.  The doctor comes in the room and checks my lungs with his stethoscope to make sure everything is clear & then checks my abdomen to make sure there aren’t any masses.  He also asks how I am feeling.  If everything is good, it’s time to go around back to the chemotherapy area.

The chemo area is basically a big room with individual cubicles.  There are curtains that can be opened and closed around each.  Across from the cubicles is the nurse’s station. In each cubicle, there is a reclining chair and the IV (intravenous) machine.  I pick the cubicle I want to sit in, take a seat, and wait for a nurse.

A nurse comes in, closes the curtain, and accesses my Medi-port.  A Medi-port is a completely implanted device that consists of the following: Reservoir – a hollow titanium disk that has a rubber septum. The reservoir is implanted in a pocket just below the skin on the chest wall. In my case, the upper left hand side, right below my collar bone.  Catheter – a tube that is connected to the reservoir and placed into one of the large veins of the chest.  In my case, into the heart.  The nurse feels for the reservoir and accesses it with a large needle.  Now ports are supposed to be good for two way flow (drawing blood and administering medication), however, my port is finicky.  Occasionally, the nurses are able to draw blood, using a number of techniques such as having me lie flat, turn my head to the right, and cough.  The nurses have also tried flushing the port with saline, heparin (a blood thinner), to no avail.  Basically my port is a bitch and only allows nurses to draw blood from it sometimes, which means the nurses have to draw blood from a vein in my left arm.  (My right arm can’t be used for blood draws, blood pressure readings, acupuncture, etc.  I had the lymph nodes removed under the right armpit.  Any injury to the right arm can cause lymphedema, which is a swelling of the arm).  It’s a real pain that my port doesn’t work like it is supposed to because instead of being stuck with a needle once, I have to be stuck twice, every week!

This is to give you an idea of what is implanted in my chest.  My mediport is slightly different.

Old pic but you can see my accessed port on the lower right hand side

Old pic but you can see my accessed port on the lower right hand side

This will give you an idea about placement of the port

This will give you an idea about placement of the port. This is Not an X-Ray of me.

The nurse draws my blood and sends it down to the lab for a CBC (Complete blood count).  Before she leaves, she opens the curtain.  Occasionally they also check my blood chemistry.  (When I see my oncologist in the city, he also draws blood for additional tests, tumor marker test and tests to see if there are any tumor cells circulating in my blood..there aren’t).  Then I wait about 15 minutes for my CBC to come back.  If my counts are too low, NO CHEMO, for reasons previously noted, especially inability to fight infections).  My counts were good!

The nurse then attaches the first IV bag through the IV machine, and attaches the tubing to the tubing at the end of the needle that was previously pushed into my port.  This bag contains the steroid and anti-nausea medication (Kytril).  This runs for about 15 minutes. When this bag is complete, the nurse comes back with the heavy stuff.  Actually two nurses come back.  I am asked my name and date of birth and then the nurses both check to make sure the poison is the correct poison.  Docetaxel aka taxotere.

The nurse removes the first bag and attaches the second.  The taxotere runs for at least an hour, meaning it takes an hour for the whole bag to enter my body.  Today, it ran longer because I kept getting back spasms so the doctor and nurses decided to run the bag slower, just in case.

During the couple hours I am there, I talk with my husband, or mom if she accompanies me, read books on my Kindle or IPad, or play games on my IPad or IPhone.  The facility does not have WI-FI.  There is a small TV but I usually don’t watch it.  As there is a TV in each cubicle, a lot of people do and the competing TV shows get annoying and makes it hard to concentrate on what you are watching.  There is also a small bookshelf with books you can borrow.  Sometimes I try to sleep, usually without luck.  The steroids keep me awake all day and into most of the night of chemo.

I also eat snacks to keep the nausea at bay.  The medical facility doesn’t have a cafeteria but they keep a bunch of snacks (graham crackers, granola bars, pretzels Oreos, cookies, etc), coffee, tea, hot chocolate, soda (especially ginger ale), and juice for the chemo patients.  Some of the chemo patients are there all day getting chemo.  As I am only getting one drug this third chemo go-around, I am not there as long. The first time I got chemotherapy (1995-1996), my doctor hospitalized me for 3 days so he could run the drug, Adriamycin, very slowly.  As I mentioned in my first post, Adriamycin or Doxorubicin is extremely toxic to the heart and I was only 28.  My doctor wanted to run it slowly to mitigate this side effect.  BTW- my heart is fine.  Now my breasts are another story.  Damn things are trying to take me out.

When the bag of taxotere is complete, the nurse comes over, disconnects the bag from the tubing leading to the needle, and then pulls the needle out of my port.  She bandages my boo-boo and then I am free to go.  Chemotherapy is done for this week.

Then the side effects start.  My side effects have been as follows:  Neuropathy (pain, numbness, and tingling) down my right leg, from my knee to my foot.  Very annoying & It makes it difficult to sleep at night.  Tingling in my face (cheeks) on the day of and day after chemo.  Tearing in my right eye.  (No I am not upset, it is a side effect of my chemo!).  This is also an annoyance, especially while trying to read, drive, write a blog…..Nausea is a biggy though I have prescriptions for Zofran and Compazine to help keep the nausea at bay.  Exhaustion.  And ….CHEMO BRAIN! Chemo Brain has to be one of the worst side effects.  I also call this side effect “CRS” or “Can’t Remember Sh*t”.  I can be in the middle of a sentence or conversation and not remember what I was talking about.  I can’t remember names.  I couldn’t remember the name of my cousin’s wife the other day.  It was embarrassing.  I think my children get a kick out of it.  I used to be a smart woman.  I don’t feel smart anymore.  I walk into a room to get something and forget why I went into the room.  Sometimes when I am driving, I forget where I am going.  I know how to get there, I just forget what I went out for.  Frustrating!!!!

I could probably write a whole blog only about chemo brain, but for now, I won’t.  I still have to get up to date with my crazy a** journey.  I haven’t even gotten into the whole re-radiation story and my job story.  But who knows, I’ll be up all night tonight so maybe I’ll catch up.  If not, Happy Easter & Blessed Passover. MCP

The journey continues

So August 22, 2012, I found out that the two lumps were cancerous and the margins weren’t clean. (Basically both of the little pearls that were removed were all cancer, so I would have to have additional surgery to make sure the cancer didn’t spread beyond the lumps into surrounding tissue).  I had additional surgery on September 13, 2013.  My nipple (which had been saved with the skin sparing mastectomy) as well as about a couple inches of skin were removed.  Thankfully, no further cancer was found.

Prior to the re-excision (as the surgery was called), my surgeon wanted me to get a breast MRI so he could be sure that there was nothing else he needed to remove.  I went to the Imaging Center, had an IV started because the surgeon wanted an MRI with and without contrast, and then found out that the tissue expanders that were implanted when I had the mastectomy were NOT compatible with an MRI.  Aargh!  It took long enough for the nurse to find a vein in my right arm, just to have the IV removed.  I wish I would have remembered to read the little card the surgeon gave me after my surgery in January, I would have saved myself some time and pain in my arm.

After the surgery in September, I went to a number of doctors.  My oncologist wanted to start me on additional chemotherapy, a six month regimen of the drug taxotere.  To lessen the side effects, he recommended I receive chemotherapy once per week for three weeks, followed by one week off.  My oncologist also wanted me to see a radiation oncologist to decide if I should receive additional radiation to my right breast.

Definitions and explanations

I got some feedback from friends regarding my first post.  There were a few technical terms that I didn’t explain.  I have been reading, writing, and living this stuff for over 17 years so I wasn’t thinking like someone brand new to breast cancer.  I will edit my previous post but for now, I will explain a few of the abbreviations, acronyms, etc that I mentioned in my previous post.  Thanks for the feedback.

Triple Negative– a type of breast cancer.  Triplenegative breast cancer refers to any breast cancer that does not express the genes for estrogen receptor (ER), progesterone receptor (PR) and Her2/neu. It is an aggressive type of breast cancer.

CMFCytoxan, Methotrexate, 5 Fluorouracil.  A breast cancer chemotherapy regimen.  I was on this regimen from February-August 2012.

FAC– 5Fluorouracil, Adriamycin, Cytoxan. A stronger breast cancer chemotherapy regimen than CMF.  I was on this regimen from October 1995-March1996.  Adriamycin is toxic to the heart.

Taxanes– a class of chemotherapy drugs, including Taxol and Taxotere (the drug I am currently taking).

Neuropathy– damage to the nerves.  In my case-pain, tingling, and numbness in my extremities (especially my feet).

mammogram– basically a breast X-Ray

sonogram– an image made from sound waves (another diagnostic tool).  A sonogram can show whether a lump is a solid mass or a cyst (fluid filled).

MRIMagnetic Resonance Imaging.  Another diagnostic tool.

OWSOccupy Wall Street

Thanks for all the feedback everyone.

My crazy a** journey

So I decided to start a blog to chronicle this wonderful, messed up journey I’ve been on because Facebook isn’t the place for everything & I’ve been wasting too much time playing games on my computer.  My life has been crazy for quite some time but this past year and change has been crazier by far.

The week before Christmas 2011, I was diagnosed with breast cancer for the SECOND time.  I was 44.  I was first diagnosed in August of 1995, at age 28, one month after giving birth to my second child (another boy).  I had my third child, a daughter, in 1998. BTW- I have no family history of breast cancer, I rarely drink, don’t smoke, and don’t have the breast cancer gene.

2011 was a pretty good year up until then.  I had been working like crazy. I had been a Captain with the NYPD for two years & really enjoyed my position (though it was very stressful).  OWS was in full force around NYC.  My eldest son was a freshman in college, my middle guy was a HS junior, and my daughter was in 8th grade.  My husband and I had been married over 21 years.

Because work was so crazy, I finally got around to getting my yearly Breast MRI in November.  My surgeon had been bugging me since August to get it done.  I had a mammogram and sonogram in February of 2011 & both were negative. Well a 1.1 cm mass was discovered in my right breast, on the MRI.  I scheduled  a needle biopsy since my radiologist didn’t seem too concerned.  (I had a needle biopsy of my left breast in June of 2011, and it was determined that I had  benign cysts).

As I already noted, I found out the week before Christmas that I had breast cancer…..again (TRIPLE NEGATIVE).  I tried to enjoy the holidays but it was difficult knowing that I was going to go through more surgery and that I may need chemotherapy..again.  My sisters, mother, cousin, and goddaughter took me out for Karaoke to try to take my mind off of the impending surgery (I love to sing).

On January 6, 2012 I had a skin sparing double mastectomy, with reconstruction.  I wouldn’t recommend it (the skin sparing part).  If you ever have a breast cancer diagnosis, get it all removed.  You’ll understand why I say this shortly.  I didn’t listen to the little voice in my head that said,  “Get rid of everything.  You don’t want to do this again!”  Instead, I listened to a doctor.  FYI- the injections for the sentinel node test hurt like crazy.

In February of 2012, I started my first of eight cycles of CMF.  My oncologist was thinking of using a regimen that included a taxane but one of the side effects is neuropathy & I already had issues resulting from work related herniated discs in my neck and back.  As my blood levels didn’t return to normal by three weeks after the first couple cycles, I started going for chemo once per month.  (In 1995-96, I had 6 cycles of FAC.  Adriamycin is very toxic to the heart, so my oncologist didn’t want to give me it again).

In July of 2012, right after my 7th cycle of chemo, I found two small lumps in my right breast in the area where my needle biopsy had been done.  I freaked out.  I called my surgeon and plastic surgeon to get an appointment.  My plastic surgeon was able to see me that day.  He gave me a prescription for a mammogram and sonogram and got me an appointment for both that same day.  I went to the woman’s imaging center and had the mammogram and sonogram.  The radiologist told me that the lumps were just lymph nodes and that I had nothing to worry about.  A couple days later, the family went on vacation.  We were away for a few weeks.  The day after we came home, I had an appointment for my 8th cycle of chemotherapy.  I had developed a cough while on vacation so my doctor wanted to wait a week before administering my final chemo.  As an afterthought, I told him about the lumps and mentioned what the radiologist said.  My oncologist recommended that I see my surgeon.

I had my 8th cycle of chemo the following week and my appointment with the surgeon the following day.  My surgeon was reading the radiologist’s report and stated that the radiologist noted that I had one lymph node.  I had felt two distinct lumps and told the surgeon so.  I had also seen two lumps on the sonogram so I didn’t understand why the report only mentioned one.  The surgeon felt the area & stated that we could keep an eye on the lumps or remove them.  I opted for removal, which was done the following day in the surgeon’s office. (The quicker the better because by the following week, my blood count would be low from the chem0).  The lumps looked like two little pearls.  The surgeon didn’t think they looked bad.

A week later, on August 22nd, I went back to the surgeon for a follow-up.  I thought everything was OK because I hadn’t heard anything from him.  (After the needle biopsy in November, he called me as soon as he got the results of the biopsy).  It wasn’t OK.  I found out that both lumps were cancer.  To say I was fu**ing pissed would be an understatement.  The lumps could have been removed a full month before had I known they were bad!  The cancer was identical to the December pathology, except that I was actually slightly estrogen positive (Further testing revealed that I was still Triple Negative. Crap!).  My surgeon & oncologist and other doctors that I have seen feel this THIRD cancer was cells that were left in the needle track during the needle biopsy in December.  Damn it! Had I had a regular mastectomy, of the non skin sparing variety, this area would have been removed and I probably wouldn’t be dealing with this crap again.  Or I would have had radiation.  But doctors don’t like to re-radiate an area & I had radiation 17 years prior.  

I thought I was going to go back to work shortly.  Instead, I was going to have more surgery, radiation (I thought doctors didn’t like to re-radiate!!), and additional chemotherapy! Ugh………………..to be continued…..