Round 2 Done – May 26, 2015

Weekly chemo treatments leave very little time to recover…or anything else.  Last Friday my infusion was only Taxol, Heceptin and magnesium (no Perjeta).  The infusion was about 6 hours, and is usually the case, I feel pretty good leaving the infusion center.  (It helped that I got a special delivery of Jamba Juice by my friend Michael.)  Which was a good thing because I went to a concert that night with my good friend Melissa and my niece.  The concert was Train, The Fray and Matt Nathanson, and it was really, really good!  We had a ton of fun.

Sunday the effects of the chemo started.  Even though I received a lower dose, the effects are cumulative.  At least I wasn’t nauseous, but I have been dealing with heartburn, stomach aches and diarrhea since Sunday.  I finally relented and took Lomotil instead of Imodium today.  Hopefully that will help.

I have been having problems with my fingers and toes.  Mild neuropathy, which is common, but on the other hand, my nails hurt.  I can’t open cans; the pressure against the nails is painful.  That means anything, like flip tops for lotion or makeup compacts, are difficult to open.  I took a closer look at my toenails, and it looks like I may lose a toenail or two.  I was fully expecting to lose my hair, but not my nails.  And I’m sad that I can’t get another pedicure for a while.  Just another day in the life of a chemo patient.

And yet I continue to be blessed.  A college friend, Ann, messaged me yesterday to let me know that she would be in town and could we get together?  She lives in CT, so it was great to spend some time with her, and she brought Garrett’s Chicago Mix, along with some hand dyed yarn and a great tshirt.  I received a beautiful bouquet of farm fresh flowers from a former work colleague, and over the weekend the best cap from another work colleague.

Of course, the best thing of all is that despite the symptoms, I’m mostly okay.  I’m managing to still do most things, both professionally and personally.  Just maybe a little slower.

2nd Part of New Protocol Starts – May 16, 2015

Yesterday I received the first dose of the 2nd part of the new protocol.  Confused?  Don’t worry, Ted can’t even keep it straight.  When my original chemotherapy (Taxotere, Perjeta and Herceptin) didn’t agree with me after 2 (of 6) rounds, the oncologist switched me to a new protocol, which is comprised of 4 rounds of Adriamycin and Cytoxan, followed by 12 rounds of Taxol, Perjeta and Herceptin.

My day actually started very early…with a 3 am wake up to catch a 5:30 am flight from LAX to San Jose.  I was in Santa Barbara for a meeting on Thursday, but needed to be back in time for an appointment with Dr. Priya at 8:40, followed by chemo at 9:45.  Because I was early, I started my chemo early at 9:15, which was a very good thing.  I was in the infusion center for 9 hours!

The infusion always starts with saline, and pre-meds.  This time the pre-meds were Benedryl and Pepcid, both of which are supposed to help with the Taxol.  That was followed by Decadron, a steroid, which I’ve been getting each treatment.  Next was Perjeta, which I received at my very first treatment back in the end of January.  It’s also the reason I am having chemo before surgery; Perjeta is approved for insurance if given before surgery, but not after.  The Perjeta was given as if I was receiving it for the first time – slowly, and I had an hour waiting period to ensure I didn’t have an adverse reaction.  Then I was given Herceptin, followed by Taxol.  And, of course, magnesium.  The 2 hour infusion of magnesium didn’t start until 3:40, and by the time it finished, and then the wrapup of flushing my port and Heparin all finished, it was 6:15.

Dr. Priya decided to go “all in” and give me the full loading doses of Perjeta and Herceptin. Velia, Dr. Priya’s nurse, came by the infusion center and said that she expressed skepticism to Dr. Priya about the wisdom of that.  She said, “You weren’t here when Caroline went through this last time…” (Dr. Priya was on leave for the first 3 months of my treatments.) Basically, Velia thought that Dr. Priya was crazy to try it.  We’ll see who’s right!

Today I’m feeling great, but I know from experience that if I start to feel poorly it’s about 3 days later.  On the other hand, I also know what to expect, what I should and shouldn’t be eating, how to handle the diarrhea and/or nausea if it starts, so my hope is that things may be okay.  I do feel fortunate that the Adriamycin/Cytoxan treatments went so well that I was able to continue working with few incidents and go on my business trips.  My trip to Charleston was highly successful on many fronts. We had successful business meetings, did a little sightseeing in the pouring rain to Fort Sumter, and transported 2 cats home! I am involved in animal transport in my spare time as a volunteer, and I love it.  One cat was a military reunification, and the other was an outright adoption of a kitty from New York.  My next trip isn’t until August now, although work is heating up with a go-live date of July 15 for a database conversion.

At my appointment with Dr. Priya, I asked her if she’d had a chance to discuss with the tumor board about shortening the Taxol treatments from 12 weeks.  She said there was general agreement that it could be shorter, but how much shorter is the question.  She said that it would be at least 8 weeks, but that she was leaning more towards 10 weeks. It will depend on how well I tolerate the Taxol.  So let’s hope I do well, and that there are no complications so that the Taxol treatments can be 10 weeks long rather than 12.  If you recall, I have a vacation scheduled in September, and would love to be as far past my surgery as possible when I go to Maui.  I know, first world problems…but I can’t tell you how much I’m looking forward to some relaxing, healing time in Maui.

It will be interesting having chemo weekly. Cramps my life a little, but it is what it is. Let’s just hope I tolerate Taxol well!

All done with #4! – May 1, 2015

Woot!  Today was the 4th and last infusion of AC (Adriamycin & Cytoxan)!  It went really well; as has been true for the last few infusions, I also needed magnesium, so I was in the infusion center for another 6 hours or so.  Adriamycin is the “red koolaid” drug that I’ve been posting on Facebook – such a pretty red color.  It’s interesting to note that there is a lifetime maximum that I can receive of Adriamycin…just think how toxic it much be! Hopefully lifesaving toxic!

So how have I been doing?  It’s so clear that within 24-36 hours after coming off Decadron (steroid) and Zofran (anti-nausea) I have 2-3 bad days.  I was able to work through most of those days this last round.  There was only one day that I really could not deal with going to work, as I was feeling just all around crappy.  Not exactly nauseous, but feeling really icky and weak.  Already not a morning person, the chemo makes mornings even tougher.  Between the icky stomach and weakness, mornings are not my favorite time of day for 4-5 days.  The weakness has persisted some, but Dr. Priya that’s expected – the cumulative effect of the chemo.  I didn’t have diarrhea this time around (yay!) and ate much more normally than in previous rounds.  I mean I had vegetables!  Part of the success this time was that I am taking iron, which can cause constipation, so I think the effect cancelled each other out.

The worst effects have been neuropathy in my fingers and toes, and canker sores at the corners of my mouth.  I get canker sores at the corners of my mouth even when not undergoing chemo; probably a herpes virus whose effects are exacerbated by lack of leafy green vegetables in my diet coupled with stress.  However, the chemo also causes sores, usually mouth sores (in the mouth as opposed to externally), but Dr. Priya wasn’t surprised and suggested some topicals I can try in addition to my usual to try to help the pain.  For the neuropathy, Dr. Priya suggested taking L-glutamine.  She says it helps 50% of patients with neuropathy, so it’s worth a shot.  I had to pick it up at a GNC store-wow that was an eye opener.  The stuff they sell in there is not in my realm of experience.  On top of that, the dosage on the powder I got is 5000 mg, and Dr. Priya wants me to take 10!  So just a few grains, I guess?  The neuropathy isn’t terrible:  mainly in the tips of my fingers and toes, it does not prevent me from walking, and it usually mostly goes away on my right hand by the next infusion.  It’s never disappeared in my left hand since the first treatment.

So what’s next?  I leave for Charleston, SC on Sunday night and am there until Thursday.  I hope I can handle being at this conference and the effects of chemo at the same time.  At least I’m not presenting!  I’ll have my first treatment of the second phase of this protocol on May 15. The next protocol is Taxol, Herceptin and Perjeta.  Since Taxol is in the family as Taxotere, I’m a little concerned about the side effects.  I’m hoping that since the dose is lower and it’s a different drug that I won’t have the same problems.   I guess we’ll just see what happens.

During today’s treatment I had a craving for Jamba Juice; through the magic of social media, my friend Michael brought one.  My hero!  Then I had a hankering for pho, and poof! through the magic of social media, 7 of us had dinner tonight.  What serendipity!  It was great to have dinner with good friends, and I had a great time.  Life is good.