It's the end of the chemo as we know it...

... and I feel fiiiiine.

I've been criminally late at updating my blog lately. The fatigue has been hitting me through my past few treatments. First, my blood cell counts are low (so low that they almost didn't give me my last chemo treatment). Secondly, I'm having hot flashes at night waking me up every few hours. Not fun, not fun at all!

Well, I've been recovering from my last chemo (woo woo!). The achiness and neuropathy were just as bad as previous treatments, but have been fading away. As I said, my fatigue is pretty bad but I anticipate that it'll get better soon as my body rebounds from my last round of toxic chemicals. In any case, the chemo was a success and shrunk the tumor down an incredible amount. Hooray for modern medicine!

Hair grows about a half inch a month, so it'll be quite awhile until my hair grows back. I'm kind of relieved about this, because after my surgeries I won't be able to lift my arms to wash my hair. No hair means problem solved!

So the question on everyone's mind is... What's next??

The plan: bi-lateral mastectomy, radiation, reconstruction. A bi-lateral mastectomy means they are going to completely remove both breasts. Hey, the things tried to kill me... I have NO attachment to them now. Why, you ask, a bi-lateral mastectomy if the tumor shrunk down to practically nothing (I'm a mind reader today, I know)? That has to do with factors like the type of breast cancer I had (see my previous post on Triple Negative), the initial size of the tumor (11 cm), and my age.

I met with my surgeon and a few plastic surgeons to try to hash this all out. I currently don't have a date set yet for surgery, but will keep everyone posted!

Chemo 7 and follow-up

Chemo #7 went off without a hitch. I felt nauseous after the pre-meds so they gave me Ativan and then it was night night time for Cristal. The next few days I spent in Atlanta for the Young Survival Coalition's Conference. I have had the same symptoms as the past few times... achiness, neuropathy, fatigue. My red and white blood cell counts are still low.

At my check-up, my oncologist ordered a couple of scans. First there was the CT Scan of my head. There is a chance of metastasis to the brain with Triple Negative breast cancer (that means that the cancer cells decide to take a family trip up to my brain, like what they see and permanently move in). Mine came back all clear. They didn't tell me whether they had found any grey matter in that head of mine though... hm...

Then there was the ever comprehensive (and ever expensive) MRI. The basic conclusion from the MRI was that the chemo worked (wasn't it supposed to?). They compared my previous scans to the current ones and the tumor had shrunk substantially. There were a few spots that still "lit up" on the screen.

So now I'm planning my surgery and reconstruction. I'm planning on a bi-lateral mastectomy (the suckers tried to kill me, chop 'em off!). It'll be about a month after the end of chemo. I'm still looking at reconstruction options.

You can pick your friends, you can pick your nose...

I had a PICC line installed today. PICC stands for "Peripherally Inserted Central Catheter". For those of us who aren't medically inclined, a PICC line is basically a more permanent version of an IV. They inserted it into a vein in my arm, which goes to an artery and then on to my heart. It will stay in my arm for the rest of chemo (usually they last for a month or two). There are two tubes that hang out of my arm, one for taking stuff out of me (drawing blood), and one for putting stuff in me (chemo).

It was really easy and not painful to get the PICC line installed. I wish I would have known that sooner, it sure beats getting stuck a bajillion times every time they try to find my veins at chemo. They used some local anesthetic (like what they use when you go to the dentist) and then a few minutes later it was done. The downside to the PICC line is that I have to make sure it doesn't get wet so there won't be any germies... infections are not allowed, no sir! Also, I have to flush the lines out daily with saline solution. I wonder if I can put my Diet Coke into a plunger and just inject it straight into my veins?

New news is new news.

I had a very eventful checkup with the oncology group. I'm very low on iron, so they ordered me to eat a steak for dinner. Deal! They said it was time to schedule an appointment with my surgeon. I also have a "treatment summary" appointment scheduled with my oncologist.

Since my veins have been disappearing and being difficult (it took three nurses four tries to stick me at my last chemo), we decided to have a PICC line installed.

Now, the most important part. I've been very achey with the Taxol and Abraxane. It makes it uncomfortable for me to sleep so I am exhausted. Then, there is the neuropathy (numbness and tingling in my fingers and feet). The neuropathy is a concern because instead of getting better over time, it only gets worse (and may be permanent). With the Abraxane, the neuropathy is more likely to reverse. The other option is to take smaller doses in more frequent treatments. This would mean I'd have three weeks of treatments, a week off, and then three more weeks of treatments, thereby extending my chemo for a few weeks. So the question is... if you had to get sick would you prefer a) a flu with a fever and the whole bit, completely knocking you out for two days, or b) a cold with a sore throat and the sniffles, but still being able to do most things for two weeks (and no cheating and saying you don't get sick or you get ebola in this hypothetical situation)? I guess I'd pick the flu. I'll just tough out the chemo for two more treatments (the side effects aren't unbearable, just uncomfortable).

Chemo #6

Two more to go! The Taxol was making the bottom of my feet hurt (neuropathy) so they switched me to Abraxane. It's a natural (as opposed to the synthetic Taxol) protein so most patients handle it better. Plus the neuropathy is more reversible. It took three nurses four tries to find a vein. Once they started the benadryl, I was out cold. I didn't wake up until a half hour after my chemo was finished. I went home afterwards and slept some more. I'm very happy that these treatments don't make me nauseous, although I was just getting the hang of how to handle the nausea when they switched me. Now I have to find a way to deal with the achiness.

New Chemo Regimen

I am more than halfway through with my chemo treatments! I finished my AC (Adriamycin and Cytoxan) and have moved on to the Taxol. Usually the Adriamycin is the hardest to tolerate, and causes the worst side effects as far as nausea is concerned. My oncology nurses were surprised I was still able to work while undergoing AC.

The Taxol was a lot easier on me. They started me with an IV bag of anti-nausea and benadryl (some people have an allergic reaction) which actually made me nauseous so they gave me some Ativan to help with that. After that it was night-night time for Cristal. I haven't had any nausea or queasiness. I haven't even needed my anti-nausea meds. Yippeee!

The worst part about the Taxol is that it causes achiness. My ankles and knees hurt which makes it difficult for me to sleep comfortably at night. This really doesn't help with the fact that I'm fatigued to begin with. Plus, weirdly enough, the bottom of my feet hurt so it makes it annoying to walk around.

Other than that, things are going ok! I'm in the home stretch for chemo.

All's well on the western front

I went in for my checkup this morning and everything is going great. The nurse practitioner could not even feel the tumor at all, and this is just after 3 treatments. Of course we're going to finish up with the remaining five because after we kill the cancer we're going to kill it a few more times for good measure.

The nurse practitioner was really pleased at how little of the side effects I've been seeing. My energy levels have been good. The nausea hasn't been too bad. My white and red blood cell counts are really good. I haven't had fevers. She says I'm a testament for someone else going through treatment. I guess I'm the 'best case'.

She also told me that the current cocktail mix (AC) is usually worse on people, so that means one more of the bad kind and then smooth sailing. I might have a bad reaction to the Taxotere, but since I've been kicking this like a rock star so far I'm banking on things going well.

Chemo #3 - Happy New Year

Well the holidays were pretty busy for me. My family came to Florida to visit (a trip that was planned pre-diagnosis) so I had a full house. In addition to that we drove to Ft. Myers to visit grandma and to Key West for fun. And in addition to that I had a doctor's appointment and a chemo treatment.

Christmas Eve: Checkup
All good news so far! The tumor has shrunk from 11 cm (about the size of a fist) to less than 2 cm (less than an inch... I don't know why they measure in metric). My white and red blood cells are holding up pretty well. I decided on shaving my head that day because the tiny pink hairs were falling out en masse, so I'm rocking the bald/hats/scarves look.

New Years Eve: Chemo #3
This time around the treatment knocked me out. I was asleep almost the entire day, woke up 5 minutes before the ball dropped and to watch the neighbors shoot off fireworks, and then back to bed. The nausea was a little worse than last time, but I'm doing well with all the other side effects.

I haven't chosen a New Years Resolution... I think getting rid of cancer is a pretty good one (and one I have to keep for once!). Right now I'm just focusing on getting through treatments and trying to enjoy as much of life as I can. Happy 2010!

All your hairs are belong to us.

I don't feel sick. Aside from an altercation with a rogue body part of mine, I feel perfectly normal. To look at me, you'd never know that I had cancer. You can't see the toxic chemicals coursing through my veins. You can't see the invasive tumor in my breast.

Until now...

My hair has been falling out in full-force. This has been quite traumatic, although I don't think people understand why. It's not a vanity issue. I don't need hair to feel pretty. This is the first physical mark of my cancer. From now on, when people look at me they'll see a "cancer patient" and associate me with the stereotypes that go along with it. And I don't feel like one, not at all.

To prepare myself for the eventual hair loss, I first dyed my hair pink. The next step was a short pixie cut and another round with pink hair dye. I'm glad I took that route. Seeing the short pink hairs fall out in the shower makes me feel like it's not actually my hair. My family keeps pressuring me to shave my head, but I just don't want to do it. Not until I have to.

A lot of people have suggested wigs, but I don't see a point in them. Are they supposed to make me less self-conscious? Because I will constantly be worried about people noticing that it's fake or off-centered or sticking up in the back. They're itchy and uncomfortable. I'm going to prefer hats and scarves.

I guess I just have to sigh and remember that I am more than my cancer. That sounds like a cliche, but it's still true.

Chemo Sabe Cristal, the Cancer Warrior

Chemotherapy wasn't nearly what I was expecting. I took this picture to show my worried friends that it isn't as scary as it sounds. I spent four hours with an IV in my arm just reading, watching a bit of Food Network, and listening to music.

First, they start me with an IV bag of anti-nausea medication. Then they flush it through with saline. Next was a plunger full of Adriamycin (which is bright red), and more saline to flush it through. Then an IV bag of Cytoxan, and yet again more saline to flush it through. By the end I had to pee SO BAD (which, fun fact for ya, came out red from the Adriamycin). My cheeks were puffy from all that extra fluid.

On the way home from the hospital the first of the nausea started to hit me. I had to ask my father not to accelerate or break very quickly or I wasn't going to make it the five miles back to my house without getting sick in my car. For the rest of the night I was feeling pretty miserable from the nausea. But, being me and completely insane, instead of resting that night I had a few friends over for a hair dyeing party. What color did I dye my hair? Pink. To handle the shock of losing all my hair, I decided that my first shock was going to be a fun one.

A woman with a plan

After seeing my oncologist my head was spinning. They sat me down for hours and explained EVERYthing. I'm doing neoadjuvant chemotherapy, which for the rest of us means chemotherapy before surgery. Then I will have surgery, and then radiation. Why chemo first, you ask? Since I am young, my cells are dividing pretty quickly which means that the chemo will be more effective. The chemotherapy works by stopping quickly dividing cells, which is why hair loss ends up being a side effect. Speaking of side effects, the oncology nurses explained the many many side effects that I will be dealing with as I go through this. They also gave me a fistful of prescriptions to get filled to manage the nausea.

The next steps are to get a PET Scan to see if the cancer has metastasized, and to get an Echocardiogram to see if my heart can handle the treatments

My chemotherapy drugs of choice:
Adriamycin and Cytoxen (for four treatments, two weeks apart)
Taxotere (for four treatments, two weeks apart)

My anti-nausea drugs of choice:
Emend, Phenergan, Zofran, Decadron, Ativan (optional)