Six Treatments Down, How Many More to Go? – June 29, 2015

I’ve had a busy week!  There’s a lot to tell!

After a relatively quiet weekend, I went in for my breast MRI on Monday.  I don’t know whether it’s because I’ve already had one or not, but it felt like the time flew by.  I also stayed somewhat cool; the last time I had a breast MRI I sweated so much I felt like I was cooked.

After the MRI, I went to the infusion center to get a blood transfusion.  Actually, “transfusion” is incorrect – it’s an infusion.  I received 2 units of blood of O negative blood (I’m O positive).  I’m an 8 gallon donor myself, but it felt odd to be on the other end of a blood donation.  I was also surprised that I received 2 units – that’s a lot of blood!  The blood was refrigerated, so it was also cold going in.  My friend Alissa dropped by with lunch and cinnamon rolls from Ikea (who knew Ikea made cinnamon rolls?).  That night, I felt kind of odd – whether it was all that extra blood or just the idea of all that blood, I don’t know, but I crashed early.  They said I would feel better almost immediately, and indeed, by Tuesday I was feeling much more peppy.

I received some great news Monday night before I crashed; Dr. K sent me a message to let me know that the breast MRI showed that my tumor had “melted away.”  We’d hoped this would happen; in fact, it’s why Dr. Ching (breast surgeon) had a clip put in where the tumor was, so that she could identify the location of the tumor if the chemo did its job. This does not mean I can forego any treatment – I will still need to finish chemotherapy, and I will still need to have surgery and radiation. The fact that the tumor is gone, though, is a relief.

The rest of the week was busy, busy, busy!  I went to the Lady A concert 2.5 hours away on Thursday, which means I got home at 2 am.  I met my friend Angie at the concert, and drove up with friends Liz and Eric.  I had chemo on Friday; another six hours at the infusion center to get Taxol, Herceptin and magnesium.  Then I headed off to see Lady A again, this time with my niece Natalie.  Our 6th row seats were on the aisle, which meant we had plenty of opportunity to press the flesh with the artists.  In fact, I received a huge hug from Charles Kelley, which was amazing.

As if that weren’t enough, on Saturday was the California Clasico – the soccer match between the San Jose Earthquakes and LA Galaxy at Stanford Stadium.  The match was a sellout this year, with almost 51,000 people attending.  The Quakes won, which was great, and the fireworks after the game were spectacular.  On Sunday Natalie, and friends Karen and Amanda came over to watch the 2nd half of season 1 of Outlander.  Sunday night we welcomed a weeklong foster, Sadie, whom we are driving to Elko, NV on Friday.  Sadie is a tiny, dainty Siamese/Tonkinese kitty of 6 pounds.   I’m having a wee problem with my friend diarrhea the past few days, but hopefully that will clear up soon.

I lost a third fingernail on Sunday.  While it’s not pretty and goodness know how long it will be before my nails are ‘normal’ again, it actually is far less painful to have no nail than it is to have a nail which is just hanging on.  There’s also the inconvenience of not having a nail – try scratching an itch with no nail – but it’s actually kind of painful to have these nails which are not attached to the nail bed. 

I have an appointment with Dr. Ching this week, and I have to say I’m kind of excited about it.  It means I’m nearing the end of my chemo treatments (except for Herceptin) and moving onto the next phase of treatment.  The real question, though, is how many more treatments do I have?  Dr. Priya is out of the office until July 13, and I haven’t had a chance to discuss with her how many treatments I’m to have.  The last time we talked about it, she mentioned 10 treatments, but apparently my chart says 8.  I have an appointment with one of the other oncologists, Dr. Colocci, on Wednesday; I suppose we’ll discuss the number of treatments left then.  For now, I’ve got chemo scheduled through July 17, which would be 9 treatments total.  That would be just fine with me.

A Good Week! – June 19, 2015

With a week off from chemo, and just receiving Taxol and Herceptin last Thursday, this week I felt pretty good.  My BP hasn’t dipped low (I stopped taking my high blood pressure meds), and I’ve been making sure to drink plenty of fluids.  Basically I drink 30 oz first thing in the morning, which ensures that I get at least 1/3 of the 90 oz they want me to drink every day from the start of the day.

On Friday I had my appointment with Dermatology, to look at all of my nails.  I wouldn’t say that was the most productive appointment:  I received an antibiotic  ointment to use when my nails start falling off; the doc told me to keep my cuticles super moist (she suggested using Aquafor, which I’m discovering is the solution for everything) to try to keep the seal that cuticles create with the nails.  She did say that my skin looks terrific for undergoing chemo, so that was a plus.  I’d already lost one fingernail by last Friday, and today I lost another when I hit the gear shift in my car just right.  Both on my right hand, I’ve lost the nail on my forefinger and 4th finger.  I think I should have invested in Band-aids! Neither nails were the ones which were infected and caused the fever.  I guess it makes sense that I’d lose fingernails first because the hands get used for all sorts of things. The toenails were first to start separating from the nail beds, but for now they’re all still there.

I was able to go to work Monday-Wednesday this week.  Yesterday I had to take my car for servicing, so I worked from there and then home.  I got a blood draw first thing in the morning.  I’ve felt pretty good all week, and had very little diarrhea.  Once was when I forgot to have some yogurt while taking antibiotics and once when I couldn’t resist and ate a lot of cherries.  I love cherry season, but eating them in the quantities I can (and do) gives me diarrhea when I’m not undergoing chemo, never mind now!  Either way, I’ve learned to manage the diarrhea pretty well.

While I was at the car shop, Dr. Priya called to tell me that she was able to prevail and that the Perjeta was approved from this point forward.  PAMF will have to apply to have the May 15 treatment retroactively approved; on my insurance site that claim’s status has changed from “Denied” to “Pending” so I’m thinking that’s a good thing.

When I got home, I got a call from Velia, who informed me that while my counts looked good (mag was low at 1.2), my hemoglobin had fallen from 9.4 to 8.1 and that I would need a blood transfusion. At today’s infusion, they took blood to be typed and crossed, and I’ll have the transfusion after my breast MRI on Monday.  A transfusion takes 4-5 hours, and there is no time for a directed donation.  I need the transfusion on Monday, and for a directed donation, Stanford Blood Bank would need to do all sorts of tests – which would take a week.  Plus, insurance won’t pay for a directed donation transfusion (surprise, surprise).  So I have to trust that Stanford Blood Bank has done its job in screening and testing the blood I’m going to receive.  Because I’m getting chemo weekly, I’m figuring that my hemoglobin doesn’t have time to recover, which also explains the urgency in getting a transfusion on Monday.

The approval of Perjeta meant that today’s infusion was Taxol, Perjeta, Herceptin, and the ever present magnesium.  We had a little trouble drawing blood from my port, which is very unusual, but eventually we got what we needed.  After the pre-meds, the blood draw, and the chemo and mag, I finally left after 7 hours.  I woke up at 4 am this morning and couldn’t go back to sleep, so I’m super tired tonight.  I suppose I might have taken the Decadron a little late last night, which could be why I didn’t sleep well.  I don’t think that will be a problem tonight.

I’m off cycle a little:  I should have received Perjeta last week.  I don’t know what that means for how many more treatments I will get, and how many more treatments of Perjeta I’ll get.  I did get a phone call today while in the center from Jennifer the nurse educator, who said that it looks from my chart that Dr. Priya was planning on 8 treatments total, and that meant I should see Dr. Ching (breast surgeon) to start preparations for surgery.  I thought Dr. Priya wanted 10 treatments, so I’ll have to ask her when I see her next, but in the meantime I’ll be scheduling an appointment to see Dr. Ching soon.

Did you catch that I mentioned a breast MRI on Monday?  Yep.  I’m going to have another one to see if the chemo is doing its job and reducing the tumor.  Neither Dr. Priya nor I can feel it anymore, so the chemo has got to be reducing it, but we can see by how much.  Dr. Priya also wanted to make sure that the chemo WAS doing its job, because why put me through all this chemo if it wasn’t working.

I’m really happy that I had the forethought to go to Sephora before I started chemo to learn how to draw eyebrows.  It’s kind of shocking to see just how few eyebrow hairs I have!  and I have exactly 1 eyelash on my left lower lid.  I wonder how long that lone soldier will last.  The hair on my head is what I’d call just really, really thin – Ted hasn’t shaved my head for a couple of weeks, so I can see the hair growing.  It’s mostly white 😦 and just thin all over my head.   I may keep a shaved head even after I’m done with chemo. I like looking badass, and I’ll save a ton on hair product!

We have a relatively quiet weekend ahead of us, which is good.  I need to finish online traffic school, write performance evaluations, and work on my conference presentations. Aside from a late lunch tomorrow with our friends Jess and Matt, we’re homebodies.  And it’s a good thing – I have an incredibly busy week ahead.  I’ll tell you all about it next time!

Disappointing News – June 4, 2015

I had my usual blood draw today, and then an appointment with Dr. Priya.  While my blood counts are good, my potassium and magnesium levels are low.  I’m sure it’s due to all the diarrhea I had this week.  In addition, my blood pressure was extremely low – 88/61. In order to help with the blood pressure, I need to drink more fluids, but with the low potassium , more fluids can make the potassium even lower.  Dr. Priya wants to give my body a few more days to recover, so I won’t be receiving chemo tomorrow.  I will go to the infusion center, but to get fluids, potassium and magnesium.

I’ll have a blood draw on Monday, and if all is better, I can have chemo on Tuesday.  The delay is disappointing, but in the end, what’s important is my health.  The labs and low blood pressure explain why I’ve felt so weak and dizzy, with headaches.  So this weekend I need to try to get the diarrhea under control, drink plenty of fluids, and eat well.

Dr. Priya is going to order another breast MRI, to make sure that the chemo is reducing the cancer.  Why continue to go through this if the chemo isn’t having an effect?  I haven’t been able to feel the lump since the first treatment, though, so it will be interesting to see what the breast MRI will show this time around.

Here’s to hoping I have  a better weekend, and that the only delay in getting chemo is until Tuesday.