Let’s start with the end today.  I received Taxol, Herceptin, 2 grams of magnesium and 1 L of saline.  I was at the infusion center for 6 hours again, and my friend Nancy brought me lunch because I forgot my lunch at home.  Thank you, Nancy!

Astute followers will note that I did not receive Perjeta which I should have this time, every 3 weeks.  I did not receive it because some lackey at Anthem Blue Cross decided to deny the Perjeta for the Taxol protocol, even though it was approved for the Taxotere protocol. It also means that right now I’m on the hook for the round of Perjeta I received in the first round of the Taxol protocol on May 15, to the tune of $26,000. I sure hope Dr. Priya is able to prevail.  It makes absolutely no sense to approve it for one protocol and not the other when both protocols are NCCN (National Comprehensive Cancer Network) approved.

Why did I get 1 L of saline?  Because when I arrived at the infusion center, I was obviously struggling and did not look great.  Indeed, my BP was 84/54.  Why was my BP so low? Apparently I didn’t drink as many fluids as I thought I did yesterday, but I also had a fever from Sunday until late Tuesday night.  Turns out that the fever was probably caused by infected fingernail beds.  I got antibiotics on Tuesday, the infections have seemed to have cleared up, and I have an appointment with Dermatology tomorrow.  I don’t know what I’ll be told, but I estimate that I’m going to lose 8 toenails and 4 fingernails. The nail loss is an extreme side effect of Taxotere. Seems I got ALL the extreme side effects of Taxotere. Lucky me.

Because I looked so terrible when I arrived, and my vitals were terrible (in addition to the low BP my pulse was 125, which meant my heart was working way too hard), Dr. Priya thought about delaying my chemo today.  Her compromise was to give me 1L of salne, recheck my vitals, and run the rest of my labs while I received the saline (over 2 hours).  I got a blood draw on Tuesday, but only a CBC to check my white blood count – to see what the fever was doing.  My WBC was fine, which is why I showed up today for my infusion. So they ran my magnesium and a basic metabolic panel, mainly to see how my potassium was doing. My potassium was normal at 3.8 (yeah, the oral meds are going the job), but my magnesium, while better, was still low at 1.3.

When I’d received about 750 mls, my vitals were taken again, and my BP was 95/66, and my pulse was lower at 116.  So we went ahead with the Taxol and Herceptin today, which made me happy.  Amazing how sleepy IV Benedryl makes me – I always end up taking a nap!  By the end of the infusions, my BP was 107/79 and my pulse was down to 109.

The facepalm of the day was the realization that I’ve still been faithfully taking my high blood pressure meds…so I’m off them for now (upon Dr. Priya’s orders and notifying my PCP), and I’ll be checking my BP every night. Hopefully that will help.

The other piece of news I received this week is that my hemoglobin is on a steady decline, and is currently 9.4.  If it goes down below 9.0, there’s a very good chance I’ll receive a blood transfusion.  It’s yet another reason for my increased dizziness, especially from a sitting to standing position; for my shortness of breath, and why I get tired more easily. Just another side effect of chemo, but having to receive a transfusion doesn’t make me very happy.  I’m hoping I can get a directed donation, which at this point looks like Ted, who is the universal donor.

I’ve had kind of a crappy 2 weeks, between the low potassium and magnesium and delay of chemo, followed by fever…At least I had a great day on Saturday.  We delivered a cat which was being transported to Arizona (I’m involved in volunteer animal transport) and then took a drive over to the coast.  It was a gorgeous, glorious day – the kind you can only find in California, and we had a lovely day.  All is not lost.  Things are looking up, and I just have to focus on the next week.  I can’t worry about things currently not in my control (like insurance approvals), and I just have to live each day at a time.  That’s how I’ll get through this.  That, and a wonderful support network of family and friends.  I’m still blessed, and I know things will be okay.