Sunshine in April

 

I forgot to thank Erica (my chosen sister) for the roller coaster reference!  Well, hers was more back to the future, like a mad scientist getting into the DeLorean.  That may fit even better.  I mean you’ve got to be some sort of mad scientist to put people through controlled poisoning that is intended to save their lives.

 

Decision Made.  Monday (11/6).  Let’s go!  I called and left a message with both my oncologist and surgeon that I have decided to proceed with neoadjuvant therapy, i.e. chemo first.

Oncologist phone conversation.  Let’s get mediport placed and check heart, hopefully next week. Geez, that is soon!  He thinks the AC-T is the better, most effective choice to go with.  UGH.  NO!  Not the worst choice.  You have to get your heart checked to have a baseline before the Adriamycin.  This sounds even worse than imagined.  For the AC-T regimen, with the goal of tumor shrinkage and killing off any cancer cells systemically (i.e. throughout the body), we will do four biweekly rounds of the A/ C combo, and twelve weekly rounds for the T.  OMG, that sounds like a lot – that is 20 weeks of chemo.  Five months of chemo.  What day of the week should we schedule for?  I opted for early in the week chemo so I could hopefully recover by the weekend.  Later that day, receptionist called to schedule chemo for Tuesday, 11/14, the week before Thanksgiving.  We’ll do the genetic testing on that same day (the appointment was already scheduled for that day).

Surgeon visit.  Tuesday.  This appointment had already been set and was initially supposed to be the pre-surgery consultation for a lumpectomy.  Now it has become the pre-surgery consultation for the mediport placement.

A recap of where we are with options for having high grade, aggressive breast cancer that is not in lymph nodes and has not spread:

• Mastectomy – take all of tumor with clear margins; extremely low chance of new tumors; makes no difference in survival odds
• Lumpectomy along with lymph node biopsy – harder to get clear margins with large size of tumor and may have to go with #1 anyway if not get clear margins
• Chemo first (neoadjuvant therapy) – going to need chemo regardless; downside is that we lose information regarding if in lymph node, which is more informational than completely necessary at this point

Mastectomy is a major surgery, so doc (oncologist as well) prefer the option of lumpectomy over mastectomy if possible.  However, the option is completely my choice and will be supported either way that I choose to proceed.  These providers know that this is a deeply personal decision with so many factors involved and the breast cancer patient has to have the empowerment to make an educated decision that best fits her needs and concerns.

The port access is a small tube in the vein in next to the superior vena cava (if I understand my notes correctly).  It goes into the main vein and is like a ‘little button’ under the skin (according to surgeon).  This is a minor outpatient surgery, and he will make a small cut into the jugular to insert tube.  WHAT?!  Going for the jugular?  WHOA!  Glad he is a vascular surgeon.  The risks are infection, clotting, and a punctured lung.  Oh, that doesn’t sound bad at all.  Hah!  It’ll only take about 30 minutes for the actual procedure and we can do it tomorrow.  Well, damn. I guess, ok!

Cardiology called as we were getting into the car and that is scheduled for Monday.

Port placement.  Wednesday. The nurse scheduler said they tend to run on time, so be prompt.  Well, not today.  They’re a little behind schedule, but not by much.  Most of the nurses were great; I did not like the one who looked at me with sad eyes – that made me want to cry.  I think I’m liking these kind and detached nurses more than the overly compassionate one.  Interesting reaction!  That darn compassionate nurse did not place my needle well.  It is so uncomfortable in my hand.  The other nurse says I’m a bit dehydrated, so she upped the ‘unflavored gatorade’ to help rehydration.  I think anxiety is making it hurt worse.  Plus, her sad pitying eyes.  Geez, lady, I’m trying to be detached from what I’m going through, now I’m all feeling everything and am not happy.  Ok, time for surgery.  I walk into the room and get on the table.  The meds work pretty quick, and I’m out, but then I feel a pinch, and the anesthesiologist must have increased the dose… I woke up to Grey and Erica’s beautiful faces.  I’m so tired and ouch!  Yes, nurse, I would like more pain meds please.  Erica has never heard me say ‘so many yes ma’ams with my (southern) accent before’.  I’m so charming! 😉

Home.  My skin feels like it is burning and is so hard to get comfortable – must be the skin stretching from the ‘little’ button’ (aka the port).  I spent the next few days on the couch, trying to get comfortable with my new ‘PowerPort’ (that is what it is called) – just plug me in or beam me up.  Grey had to remind me a few times that I did just have surgery and needed to take it easy.  Glad my couch is comfy and reclines.  My new bed for now.  Reading the cancer boards, I see that so many people did not have any problems adjusting to their port – I don’t want to be special here.  I am already ready to be done with this shit and feel good again.

Echocardiogram.  Monday 11/13.  Here I am thinking I am going to be a big kid and take myself to this appointment.  I mean most everyone works and would have to take time off to go with me.  I’ve got this.  Well, maybe not.  I sat in waiting room, wanting to cry and wishing I would have moved outside of my stubbornness and asked someone to go with me.  It really is hard to see into your own habits and implicit rules of life (i.e. so used to doing things by myself and not ‘bothering’ others).  Other than a bit of discomfort as I was still adjusting to the port, everything went smoothly and looks good.  I have a ‘strong heart and good lungs’.  YEAH for loving to exercise and trying to stay healthy!

 

Life.  Through this so far month-long process, life is still going on.  I am teaching my classes as I want to finish out the quarter.  I don’t like giving up on my students or want them to have to change instructors this late in the quarter.  Just a few more weeks, and the quarter will be over.  Mikala still has to be at school every day, along with ortho appointments every six weeks with dental visits mixed in there for more frequent cleanings with the braces on.  We all still need to eat, take care of household chores, take care of other chores… Oh, and on top of this we are remodeling our bathroom and putting down new flooring and paint throughout the house.   No problem, we’ve go this!

Next step:  Chemo.  OMFG!  I am so scared.

 

Current status:  I just had my forth of twelve Taxol treatments.  The side effects continue to be much easier than the A/C combo, but still taking their toll.  The hardest factors are the digestive issues (slowed to a crawl…), the chemically induced menopause (Hot/cold/hot/cold… beanie and jacket off/beanie and jack back on/ back off / back on…), and the insomnia (especially chemo night, which only results in about four hours with sleep aids).  Other than the bald head and starting to lose eyebrows and eyelashes, I am not losing weight or having too rough of an impact on skin discoloration.  People seem shocked to see me as I think most expect an emaciated super sick looking cancer patient.  I am fighting back with all of my might.  Going in healthy and drinking LOADS of water seem to be helping immensely.