I went in for my infusion of potassium and magnesium, and the 4 hour drip was a breeze.  My BP was 108/80 today, and while my pulse was 128 when I arrived by the time I finished it was down to 99.  All good signs that the drip did its thing.  The question now is whether I can keep my potassium and magnesium levels okay.  Given that I had diarrhea today, I’m not very confident, but I’ll be more careful about what I eat and much more diligent in taking Lomotil or Imodium after every bout.

The bad news is that currently I’m scheduled for chemo on Thursday, which means I’ve essentlally missed a week.  The reason, other than to give my body a chance to recover, has to do with insurance.  If you recall, the reason I’m having chemo first then surgery was that one of the drugs for my type of cancer – Perjeta – is only approved by insurance for neoadjuvant therapy, so the typical order of surgery, chemo, radiation was altered to be chemo, surgery, radiation.  The reason it’s important to have insurance pay for Perjeta is that it’s $26,000 a treatment.  My insurance has paid for the Perjeta I received in January; I received it again when I started this new protocol of Taxol with Perjeta and Herceptin 4 weeks ago.  It’s not clear whether that treatment was approved, but I do know that Dr. Priya needs to do a peer-to-peer justification for me to receive more.  That justification is on Monday, and in order to give the review some time, PAMF didn’t want to schedule me for chemo on Tuesday.  By the time this was all figured out, Wednesday was booked, so here I am, scheduled for chemo on Thursday.  My infusions are super long, 5-6 hours, so it’s not like they can slot me anywhere for an infusion.  Still, I asked if there was a cancellation on Tuesday or Wednesday and if my treatment was approved if they could call me.

I know I shouldn’t be so focused on the timing for my vacation, but while I am going to relax and heal, I still want to have some fun.  I just have to relax and have faith that it will all work out.  One option that Dr. Priya mentioned is that I could also have chemo after surgery – but if that’s the case, I won’t be receiving Perjeta, unless that therapy is approved for adjuvant therapy in the intervening months.  She could decide that 6 rounds of Taxol is enough.  (I think my body would agree with that…)  The puzzling thing is that Taxol is supposed to cause constipation; Perjeta can cause diarrhea, but any Perjeta when this protocol first started is well out of my system.  The diarrhea has gotten worse, so I’m convinced my body simply does not like the Taxene family of chemo drugs.  I’ll gladly take the Red Devil over any Taxene drug…but there’s a lifetime maximum of Adriamycin.

So…good and bad.  I’m feeling tired but okay right now.  Certainly I do not have any dizziness, some weakness is normal.  I’m drinking a lot, and need to remember to continue to drink a lot.  I probably am not drinking enough, especially considering the diarrhea.  Let’s hope things improve this weekend.