When I lost my hair at age 17, I got a wig. There wasn't much available at the wig shop for a teenager, so I ended up with a big, curly, reddish wig my sister and I dubbed "Dottie," for the singer Dottie West. I wore the wig all the time - even in summer marching band and, after for some reason I had to get a new wig (no fun name this time), cross country.
If for some reason I would ever lose my hair again, I figured I wouldn't get a wig again. I was no longer a self-conscious teenager, and didn't want to deal with the hassle of a wig. But I'm planning to continue working, and that means traveling to new clinical sites and meeting new people. And I don't really want the first thing people to know about me be cancer patient. It's not that I'm embarassed or unwilling to talk about it, I just don't want to be thought of as sickly, I guess. (Tangent Alert: after my senior year of high school, about six months after my bone marrow transplant (no wig anymore), I went to Washington DC to march in the 4th of July parade with my marching band (we won). The weather was hot and our uniforms were not light. After we finished, people were feeling faint. Everyone would come up to me and ask how I was doing (it really was a lot of people). I was fine. A friend started feeling faint, so I ran over to the chaperone/doctor (did I mention I ran?). As soon as they saw me, everyone started asking me what was wrong, what did I need - I had a hard time insisting it was my friend who needed the help!)
So a couple weeks ago, I bought a wig. I'm not sure how much I'll wear it versus hats, but it's nice to have the option. I also feel it might offer a sense of normalcy.
A few days after round one, I got my hair cut. It's still a few inches long, but a change. Since I was told that I would lose my hair two to three weeks after my first chemo, I asked my brother to bring his electric shaver to our family Christmas. Tuesday my scalp started to hurt a bit, and if I ran my fingers through my hair I felt I had more hair than usual in my hand (I generally shed about as much as my cat). But it wasn't enough for me to be ready for a shave. Wednesday the scalp ache went away and I headed home. Of course, yesterday morning I started losing small clumps of hair in the shower. It was fine the rest of the day since I wasn't touching it. Today, though, I was too nervous to shower and style it - and I figure if I can't style it, it's time for it to go. Plus I want to ski with the ski team tomorrow, and I'm worried about trying to pull a hat on. So I have an appointment with Ramona, Becky, and an electric shaver a 8:00 tomorrow morning.
Friday, December 30, 2011
Round Two
As I write this, I'm sitting at the University of Minnesota, receiving my next dose of chemotherapy. Things got started at 8, when I showed up (thanks for the ride, Heather!) and had my counts checked. I was a bit nervous that my counts wouldn't be high enough to go ahead, as I'm only at Day 17 and they usually only allow up to two days either side of 21 days. But everything looked good, so I was sent upstairs to begin.
Before chemo started, I was given two anti-nausea drugs, Emend and Aloxi, along with the steroid Decadron. Then I received the taxotere (aka docetaxel). They run this one in more slowly, as people can have allergic reactions to this drug (which is why they give the steroid). Next time they can run it faster, as I haven't had any reactions.
Fast forward eleven hours. Docetaxel and cytoxan were both infused without incident. My friend Alyssa brought lunch (thanks!) and gave me a ride home, where I had an hour before acupuncture. I did start feeling some slight nausea and heartburn at this time, but they went away shortly afterward. Ginger tea may also have helped. (:
This evening, friends Ramona and Becky came over and made dinner (more thanks!). I was a bit tired after chemo, but by now I was wide awake and chatty (and still am - I'm drinking Sleepytime tea to help calm me down). Starting the evening of chemo day, I take a steroid (Decadron) for three days to help minimize reactions to the docetaxel. I also received it IV earlier today. Possible side effects of decadron include fatigue, emotional outbursts, spaciness (my term) and hyperactivity. I think I know which one I got!
On our way out, Alyssa mentioned how they really have the therapy delivery down to an exact process. They really try to make everything as pleasant as possible. The space is very pleasant, TVs are available to everyone, and so are snacks and beverages.
This morning I brought my laptop, all six seasons of Sex and The City (thanks, Pat!), a magazine, and a book. But time really flew, even though I didn't finish until 1:30 - I only watched one and a half episodes, didn't touch my book or the magazine, and didn't do enough blogging. My nurse is also a cross-country ski coach, biked to work today, and shops at a coop - I did talk to her a lot. Maybe too much. At the end, they kind of had to kick me out because I was chatting rather than leaving and they needed my "pod." Did I mention that I had received Decadron IV?
Before chemo started, I was given two anti-nausea drugs, Emend and Aloxi, along with the steroid Decadron. Then I received the taxotere (aka docetaxel). They run this one in more slowly, as people can have allergic reactions to this drug (which is why they give the steroid). Next time they can run it faster, as I haven't had any reactions.
Fast forward eleven hours. Docetaxel and cytoxan were both infused without incident. My friend Alyssa brought lunch (thanks!) and gave me a ride home, where I had an hour before acupuncture. I did start feeling some slight nausea and heartburn at this time, but they went away shortly afterward. Ginger tea may also have helped. (:
This evening, friends Ramona and Becky came over and made dinner (more thanks!). I was a bit tired after chemo, but by now I was wide awake and chatty (and still am - I'm drinking Sleepytime tea to help calm me down). Starting the evening of chemo day, I take a steroid (Decadron) for three days to help minimize reactions to the docetaxel. I also received it IV earlier today. Possible side effects of decadron include fatigue, emotional outbursts, spaciness (my term) and hyperactivity. I think I know which one I got!
On our way out, Alyssa mentioned how they really have the therapy delivery down to an exact process. They really try to make everything as pleasant as possible. The space is very pleasant, TVs are available to everyone, and so are snacks and beverages.
This morning I brought my laptop, all six seasons of Sex and The City (thanks, Pat!), a magazine, and a book. But time really flew, even though I didn't finish until 1:30 - I only watched one and a half episodes, didn't touch my book or the magazine, and didn't do enough blogging. My nurse is also a cross-country ski coach, biked to work today, and shops at a coop - I did talk to her a lot. Maybe too much. At the end, they kind of had to kick me out because I was chatting rather than leaving and they needed my "pod." Did I mention that I had received Decadron IV?
The Rest of Round One (or "Ode to Versed")
The last couple of weeks have been filled with medical appointments, acupuncture, and Christmas preparation and celebration. I continued to feel good during round one, with my main complaint being the bone pain from the Neulasta injection. The fifth and sixth days after the injection I would get an intense, pulsating pain in my low back. It kept me from sleeping even after taking two Vicodin! But I would rather deal with something like pain than nausea or just the ickiness of feeling unwell. My energy level and appetite have remained high. I know how bad it can be, though, so I'm going to refrain from my usual jokes about how I wish my appetite weren't so good... It's not a guarantee, but the good experience I've had with round one is hopefully a sign that all four rounds should go fairly smoothly.
Thursday the 22nd I had an MRI of my arm. I was almost due, but my arm did light up a bit on the PET scan (likely due to the inflammation) so Dr. O wanted to get it done - and I was ok with that. However, I was concerned about going through another MRI - if you've read previous blog posts you might know that for my arm I'm in the MRI machine a long time, and last time was quite uncomfortable, started hyperventilating, and had to be pulled out of the machine twice. In addition, the pain from the recent pnuemothorax was quite similar to that I felt while lying in the MRI tube (there must be something to this - if I figured it out, maybe I would figure out what's going on with the MRI. Any ideas?), so I was even more concerned about going through another MRI at this time. Also, prior to my PET scan I had taken an Ativan (an anti-anxiety medication), and it didn't seem to make much of a difference - I had the same pain toward the end of that exam as well. As a result of all this, I ended up having IV sedation during the MRI - made even more convenient by having my port.
Totally the way to go. A nurse was near me the whole time. I would raise my index finger if I needed the anti-anxiety med (Versed), another if I needed the pain med (Fentanyl). It didn't take care of all the pain and anxiety, but definitely lessened it. And made the time go much faster! I'm requesting Versed and Fentanyl for every MRI I ever have on my arm again.
I'm not a stranger to versed. A bone marrow test is how the presence or absence of leukemia cells is assessed. Twenty years ago, I had many, many bone marrow tests. The first one or two were done just with xylocaine, a local pain med. Then Demerol was added. That, experience, and increased confidence regarding the results increased the ease of the tests. But then, shortly after my transplant, when I still had a port, I had Versed. Wow, I'm not even sure I knew I had a bone marrow test. I also have received Versed as heading from pre-op to surgery a few (five!) times this year.
Contrary to how all this sounds, I'm not a pill taker. This last year, I needed to be encouraged to take pain meds. I didn't even have Tylenol in my house when the bone pain started (thanks, Pat!). But when it comes to Versed (ok, maybe Demerol too), I'm all over it.
Back to the MRI. Got the results the next day at my appointment with Dr. Blaes, then talked to Dr. O's nurse that evening. No sign of recurrence! My arm is quite swollen - more so than in the October scan - but everything else looked good.
To recap: PET scan, good. Lymph node, no sign of cancer. Arm, looking good. Just have to worry about that pesky, 1.3 cm lone tumor. And we're taking care of that right now (I'm actually sitting receiving round two as I write this).
Thursday the 22nd I had an MRI of my arm. I was almost due, but my arm did light up a bit on the PET scan (likely due to the inflammation) so Dr. O wanted to get it done - and I was ok with that. However, I was concerned about going through another MRI - if you've read previous blog posts you might know that for my arm I'm in the MRI machine a long time, and last time was quite uncomfortable, started hyperventilating, and had to be pulled out of the machine twice. In addition, the pain from the recent pnuemothorax was quite similar to that I felt while lying in the MRI tube (there must be something to this - if I figured it out, maybe I would figure out what's going on with the MRI. Any ideas?), so I was even more concerned about going through another MRI at this time. Also, prior to my PET scan I had taken an Ativan (an anti-anxiety medication), and it didn't seem to make much of a difference - I had the same pain toward the end of that exam as well. As a result of all this, I ended up having IV sedation during the MRI - made even more convenient by having my port.
Totally the way to go. A nurse was near me the whole time. I would raise my index finger if I needed the anti-anxiety med (Versed), another if I needed the pain med (Fentanyl). It didn't take care of all the pain and anxiety, but definitely lessened it. And made the time go much faster! I'm requesting Versed and Fentanyl for every MRI I ever have on my arm again.
I'm not a stranger to versed. A bone marrow test is how the presence or absence of leukemia cells is assessed. Twenty years ago, I had many, many bone marrow tests. The first one or two were done just with xylocaine, a local pain med. Then Demerol was added. That, experience, and increased confidence regarding the results increased the ease of the tests. But then, shortly after my transplant, when I still had a port, I had Versed. Wow, I'm not even sure I knew I had a bone marrow test. I also have received Versed as heading from pre-op to surgery a few (five!) times this year.
Contrary to how all this sounds, I'm not a pill taker. This last year, I needed to be encouraged to take pain meds. I didn't even have Tylenol in my house when the bone pain started (thanks, Pat!). But when it comes to Versed (ok, maybe Demerol too), I'm all over it.
Back to the MRI. Got the results the next day at my appointment with Dr. Blaes, then talked to Dr. O's nurse that evening. No sign of recurrence! My arm is quite swollen - more so than in the October scan - but everything else looked good.
To recap: PET scan, good. Lymph node, no sign of cancer. Arm, looking good. Just have to worry about that pesky, 1.3 cm lone tumor. And we're taking care of that right now (I'm actually sitting receiving round two as I write this).
Monday, December 19, 2011
Lymph Node Biopsy
I forgot to post a major event - the biopsy of the lymph node revealed no signs of cancer! That plus the PET scan results mean that the cancer has not spread beyond the breast.
I am working to schedule the MRI of my arm. Because the pneumothorax pain is similar to the issues I have during MRIs and the PET scan (it makes it hard to lie still during acupuncture as well), I may be having IV sedation this time...
I am working to schedule the MRI of my arm. Because the pneumothorax pain is similar to the issues I have during MRIs and the PET scan (it makes it hard to lie still during acupuncture as well), I may be having IV sedation this time...
First Week (Almost) Down
Almost one week after my first chemo treatment, I'm feeling pretty good. My biggest issue right now is bone pain from the Neulasta shots that are given to help boost my white blood cell count. Neulasta is generally given 24-72 hours after each chemo infusion, as a subcutaneous shot. It makes its way to the bone marrow, and somehow helps it start producing white blood cells. I got my shot on Thursday, and Friday I started feeling pain in my low back and hips. I was pretty good over the weekend and this morning, but then it started - and intensified - this afternoon and evening. I took tylenol at 6:00, then moved to something stronger at 10. I'm still waiting for the pain reliever to kick in. The pain is weird - any time I make any slight move, I get intense waves of pain coinciding with my heart beat. I think it's better when I walk. Bending over or squatting is bad.
Thursday evening I was feeling pretty good and decided to try a spin class. The pain from the pneumothorax prevented me from being able to bend over the handlebars - I spent the whole class upright like I was riding a unicycle. I guess it's just walking for me for a while yet. I see the surgeon Friday, but I may call his office tomorrow to see what they say about ski practice.
Wednesday I got my hair cut. It looked pretty shocking at first, especially since it got extra curly - I thought I looked like a lamb. It's definitely a lot easier to style! I will post a picture if one can be taken of me where I keep my eyes open! I'm told it will be 2-3 weeks before my hair falls out, last night my scalp started feeling kind of itchy, turns out it could stay itchy until it starts hurting, that's when I know it's time to get out the shaver. I did buy a wig, I initially planned to have it just for work and travel functions, but I think I may end up wearing it more as it may be nice to have the sense of normalcy. I did find a website with some cute hats and headcoverings (headcovers.com) for women experiencing hairloss, and my good friend Ramona has offered to host a "Hat Party" for me. Stay tuned.
Other than the pneumothorax and the bone pain, side effects have been pretty minimal. No nausea, no major fatigue, maybe some heart burn and fluid retention. I think I would rather have the pain than the nausea. Tomorrow I'll have my fourth acupuncture session.
Thursday evening I was feeling pretty good and decided to try a spin class. The pain from the pneumothorax prevented me from being able to bend over the handlebars - I spent the whole class upright like I was riding a unicycle. I guess it's just walking for me for a while yet. I see the surgeon Friday, but I may call his office tomorrow to see what they say about ski practice.
Wednesday I got my hair cut. It looked pretty shocking at first, especially since it got extra curly - I thought I looked like a lamb. It's definitely a lot easier to style! I will post a picture if one can be taken of me where I keep my eyes open! I'm told it will be 2-3 weeks before my hair falls out, last night my scalp started feeling kind of itchy, turns out it could stay itchy until it starts hurting, that's when I know it's time to get out the shaver. I did buy a wig, I initially planned to have it just for work and travel functions, but I think I may end up wearing it more as it may be nice to have the sense of normalcy. I did find a website with some cute hats and headcoverings (headcovers.com) for women experiencing hairloss, and my good friend Ramona has offered to host a "Hat Party" for me. Stay tuned.
Other than the pneumothorax and the bone pain, side effects have been pretty minimal. No nausea, no major fatigue, maybe some heart burn and fluid retention. I think I would rather have the pain than the nausea. Tomorrow I'll have my fourth acupuncture session.
Monday, December 12, 2011
Surgery Update
Surgery went well, they took one lymph node. It was very clear this was the one sentinel node, based on how it took up the dye. I guess you can also use the dye to make a guess about cancer in the lymph node, and everything looked good for me. Of course, pathology is the final assessment - it will take a day or two to get those results.
The incision is small and doesn't hurt - I can't even tell where in my armpit it is. As for the port, that's starting to hurt a bit as the meds wear off.
I had the choice to not go under general anesthesia, so did that. I didn't notice any difference. (;
One of the final things they do prior to discharge is a chest x-ray to check the port placement. And turns out I have a pneumothorax - they punctured my lung with a needle. Which meant I couldn't go home. Off to the 7th floor, where I was admitted for overnight observation.
Picking up where I left off last night. The pneumothorax has not shrunk, and has maybe even gotten a bit bigger. My oxygen saturation is still high (upper 90s as opposed to 100 prior to surgery), but it's not very comfortable when I move around. The armpit incision also started hurting, but that was taken care of with a bit of vicodin.
Pneumothoraxes (pneumothori?) can resolve on their own, or they can insert a tube in your chest to suck out the air. I'm currently waiting for the surgical team to stop by during rounds to see if yesterday's surgeon thinks a tube is required. Also if it will impact chemo, which is scheduled to start at 8:30 this morning.
Already I'm behind on my meds - I was supposed to start a steroid yesterday to help prevent nausea. You take it the day before, the day of, and the day after each chemo infusion. I also haven't eaten anything for about 30 hours, first due to surgery prep, and now in case I need surgery again. My stomach is rumbling as I write.
Hopefully I will get some more news soon.
The incision is small and doesn't hurt - I can't even tell where in my armpit it is. As for the port, that's starting to hurt a bit as the meds wear off.
I had the choice to not go under general anesthesia, so did that. I didn't notice any difference. (;
One of the final things they do prior to discharge is a chest x-ray to check the port placement. And turns out I have a pneumothorax - they punctured my lung with a needle. Which meant I couldn't go home. Off to the 7th floor, where I was admitted for overnight observation.
Picking up where I left off last night. The pneumothorax has not shrunk, and has maybe even gotten a bit bigger. My oxygen saturation is still high (upper 90s as opposed to 100 prior to surgery), but it's not very comfortable when I move around. The armpit incision also started hurting, but that was taken care of with a bit of vicodin.
Pneumothoraxes (pneumothori?) can resolve on their own, or they can insert a tube in your chest to suck out the air. I'm currently waiting for the surgical team to stop by during rounds to see if yesterday's surgeon thinks a tube is required. Also if it will impact chemo, which is scheduled to start at 8:30 this morning.
Already I'm behind on my meds - I was supposed to start a steroid yesterday to help prevent nausea. You take it the day before, the day of, and the day after each chemo infusion. I also haven't eaten anything for about 30 hours, first due to surgery prep, and now in case I need surgery again. My stomach is rumbling as I write.
Hopefully I will get some more news soon.
PET Scan Results
Of course, the doctor called while I was taking the garbage out this morning, but in her message she said they DID NOT see any other signs of cancer in my body. She is supposed to call back later to go over the results, but I'm so glad she did say that about the no signs of cancer - RELIEF!
I am going in for surgery at 10:30 today, so will update my blog as more information becomes available and I have time to do the update. I will be under general anesthesia, but not admitted - I hope to be home by dinnertime.
I am going in for surgery at 10:30 today, so will update my blog as more information becomes available and I have time to do the update. I will be under general anesthesia, but not admitted - I hope to be home by dinnertime.
Sunday, December 11, 2011
A New Diagnosis
It's been a while since I posted, but not for lack of news.
On November 16th I learned that I now have breast cancer. I had started getting mammograms and breast MRIs a few years ago due to my increased risk after the total body irradiation. I received my annual reminder letter in August. As you may remember, at that time I was going through radiation for my arm. I made sure that I could have the testing while undergoing radiation, that my insurance (which had changed since the previous year) would cover it, and then I sat on it. I finally scheduled everything for November 3rd. Then, November 1st I found a lump.
An MRI, mammogram, ultrasound, and needle biopsy later, I received my third cancer diagnosis of 2011 (I had a basal cell carcinoma removed in September). The tumor is fairly small (1.3 cm - Stage 1), the lymph nodes looked normal on MRI (but a biopsy will be done to make sure they're clear), and the prognosis is good. However, the suggested treatment regimen includes chemo, followed by lumpectomy plus radiation or mastectomy.
There are multiple types of breast cancer, which vary in their responses to treatment, in their aggressiveness, and are actually thought to be different diseases. My type is referred to as triple negative, as it is negative for estrogen receptors, progesterone receptors, and Her2/neu. Triple negative breast cancer is more common among younger women, is considered to be aggressive, does not respond to hormonal therapy, but responds well to chemo.
Because much of my anxiety post-diagnosis was regarding the fact that this happened so quickly after the MPNST treatment, I was scheduled for a PET scan. A PET scan looks for possible cancer cells in the whole body - radioactive glucose is injected into the body prior to the scan. Because cancer cells have a higher metabolism than other cells, they take up more of the radioactive glucose and are visible on the scan. It's commonly done when metastasis is suspected, so not standard in my case if it was the breast cancer alone. The PET scan was Friday; I was hoping to receive the results yet that day but didn't hear anything. I'm trying to stay positive.
Chemotherapy will include four rounds of the drugs cytoxan and taxotere (CT), given three weeks apart. I am going to receive chemo prior to surgery to remove the tumor; this way, they can use MRIs to assess whether the tumor is responding the the chemo (chemo is given to kill any "micrometastases" that have broken away from the primary tumor - if the cells of the primary tumor respond, then these cells are likely responding as well. If the tumor is removed prior to chemo, you can't know this). If the tumor doesn't shrink, they can change my drugs. Best case scenario is that the tumor disappears. (I would still have surgery - a little metal clip was placed in the tumor during the needle biopsy, and the surgeon would remove this clip and the surrounding tissue.) I am starting chemo Tuesday, December 13th (yes, two days from now).
First, though, I am having surgery to place a port and to do a sentinel lymph node biopsy. A port is a little catheter placed under the skin underneath the collarbone that allows IV medicines to be given without the need for multiple needle sticks. It will look like a little button sticking out of my chest. For the lymph node biopsy, a blue tracer dye will be injected into the breast, and followed to the first (or first few) lymph node it reaches. This lymph node will be removed and examined for any signs of the cancer spreading. I think 1-3 lymph nodes are typically removed, a lot less than before the sentinel procedure was introduced and thereby reducing the risk of lymphedema. Surgery is tomorrow (Monday, December 12th).
The days since November 1st, when I found the lump, have flown by, while at the same time I freak out about six weeks passing between discovery and start of treatment. There were a number of people with whom I wanted to speak in person before updating this blog, which took a lot longer than I expected. Plus I've been spending a great deal of time reading, on the internet, on the phone, and at doctor appointments. Once again, I'm realizing that battling cancer can be a full time job! The last few days I've been trying to get stuff done so I can get it out of the way prior to chemo, when I don't know how I'll feel.
One of the things I've done is purchase a wig. I didn't think I'd wear a wig again, but then I started thinking about work travel, and meeting the staff at my study sites. I don't want baldness to be the first thing they notice about me. As for the rest of the time, I'm looking for cute hats, have some turbans that I bought back in 1989, and would use scarves if I can figure out how to tie them! After trying on wigs, though, I thought maybe I would wear the wig more than I first thought - it's nice for bestowing a sense of normalcy.
I also had my first acupuncture session. The possible side effects of chemo include fatigue, loss of appetite, edema, constipation, and diarrhea (sorry if that's TMI), and vary among individuals. A few things I've heard about getting through chemo: hydrate, hydrate, hydrate (one of the metabolites of cytoxan is toxic to the bladder, plus the more you drink the faster you get all those toxins out of your body), understand your side effects so you can be prepared for them the next round, exercise (which is the one thing scientifically shown to help combat fatigue), and consider acupuncture.
I will try to update this blog more frequently the next few days as I learn the results of the PET scan, the lymph node biopsy, and go through my first chemo infusion.
On November 16th I learned that I now have breast cancer. I had started getting mammograms and breast MRIs a few years ago due to my increased risk after the total body irradiation. I received my annual reminder letter in August. As you may remember, at that time I was going through radiation for my arm. I made sure that I could have the testing while undergoing radiation, that my insurance (which had changed since the previous year) would cover it, and then I sat on it. I finally scheduled everything for November 3rd. Then, November 1st I found a lump.
An MRI, mammogram, ultrasound, and needle biopsy later, I received my third cancer diagnosis of 2011 (I had a basal cell carcinoma removed in September). The tumor is fairly small (1.3 cm - Stage 1), the lymph nodes looked normal on MRI (but a biopsy will be done to make sure they're clear), and the prognosis is good. However, the suggested treatment regimen includes chemo, followed by lumpectomy plus radiation or mastectomy.
There are multiple types of breast cancer, which vary in their responses to treatment, in their aggressiveness, and are actually thought to be different diseases. My type is referred to as triple negative, as it is negative for estrogen receptors, progesterone receptors, and Her2/neu. Triple negative breast cancer is more common among younger women, is considered to be aggressive, does not respond to hormonal therapy, but responds well to chemo.
Because much of my anxiety post-diagnosis was regarding the fact that this happened so quickly after the MPNST treatment, I was scheduled for a PET scan. A PET scan looks for possible cancer cells in the whole body - radioactive glucose is injected into the body prior to the scan. Because cancer cells have a higher metabolism than other cells, they take up more of the radioactive glucose and are visible on the scan. It's commonly done when metastasis is suspected, so not standard in my case if it was the breast cancer alone. The PET scan was Friday; I was hoping to receive the results yet that day but didn't hear anything. I'm trying to stay positive.
Chemotherapy will include four rounds of the drugs cytoxan and taxotere (CT), given three weeks apart. I am going to receive chemo prior to surgery to remove the tumor; this way, they can use MRIs to assess whether the tumor is responding the the chemo (chemo is given to kill any "micrometastases" that have broken away from the primary tumor - if the cells of the primary tumor respond, then these cells are likely responding as well. If the tumor is removed prior to chemo, you can't know this). If the tumor doesn't shrink, they can change my drugs. Best case scenario is that the tumor disappears. (I would still have surgery - a little metal clip was placed in the tumor during the needle biopsy, and the surgeon would remove this clip and the surrounding tissue.) I am starting chemo Tuesday, December 13th (yes, two days from now).
First, though, I am having surgery to place a port and to do a sentinel lymph node biopsy. A port is a little catheter placed under the skin underneath the collarbone that allows IV medicines to be given without the need for multiple needle sticks. It will look like a little button sticking out of my chest. For the lymph node biopsy, a blue tracer dye will be injected into the breast, and followed to the first (or first few) lymph node it reaches. This lymph node will be removed and examined for any signs of the cancer spreading. I think 1-3 lymph nodes are typically removed, a lot less than before the sentinel procedure was introduced and thereby reducing the risk of lymphedema. Surgery is tomorrow (Monday, December 12th).
The days since November 1st, when I found the lump, have flown by, while at the same time I freak out about six weeks passing between discovery and start of treatment. There were a number of people with whom I wanted to speak in person before updating this blog, which took a lot longer than I expected. Plus I've been spending a great deal of time reading, on the internet, on the phone, and at doctor appointments. Once again, I'm realizing that battling cancer can be a full time job! The last few days I've been trying to get stuff done so I can get it out of the way prior to chemo, when I don't know how I'll feel.
One of the things I've done is purchase a wig. I didn't think I'd wear a wig again, but then I started thinking about work travel, and meeting the staff at my study sites. I don't want baldness to be the first thing they notice about me. As for the rest of the time, I'm looking for cute hats, have some turbans that I bought back in 1989, and would use scarves if I can figure out how to tie them! After trying on wigs, though, I thought maybe I would wear the wig more than I first thought - it's nice for bestowing a sense of normalcy.
I also had my first acupuncture session. The possible side effects of chemo include fatigue, loss of appetite, edema, constipation, and diarrhea (sorry if that's TMI), and vary among individuals. A few things I've heard about getting through chemo: hydrate, hydrate, hydrate (one of the metabolites of cytoxan is toxic to the bladder, plus the more you drink the faster you get all those toxins out of your body), understand your side effects so you can be prepared for them the next round, exercise (which is the one thing scientifically shown to help combat fatigue), and consider acupuncture.
I will try to update this blog more frequently the next few days as I learn the results of the PET scan, the lymph node biopsy, and go through my first chemo infusion.
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