Visit with Surgeon

My surgeon, Dr. Wapnir, saw me Monday immediately after my chemo. Since I haven't had my follow-up tests yet, she didn't have a recommendation for me. But she did want me to consult with a reconstructive plastic surgeon. I have an appointment with him tomorrow.

Next week I have an MRI, mammo and ultrasound scheduled. I see my oncologist at the end of the week, then I see Dr. Wapnir again the following Monday.

I told Dr. Wapnir I didn't want surgery if at all possible. The idea of being cut up scares me. She thinks I'm being unreasonable. 

MD Anderson is conducting a study to see if women who achieved pCR (pathologic complete response) after chemo can avoid surgery. They will receive radiation without surgery instead. The goal is to see if patients are being overtreated. 

The Stanford study I'm participating in where my drugs were reduced from four to three and the duration from six to four treatments (although the number of treatments changed when I switched to Taxol) -- it has the same goal to see if women are being overtreated.

Chemo #8

Monday was my last chemo. Note that I still need to take Herceptin and Perjeta every three weeks till December. Those are classified as targeted drugs, not chemo drugs.

My potassium is still low, and they gave me potassium pills again. But instead of two giant pills, they gave me six slightly smaller pills that were easier to swallow. 

The nurse noticed rashes on my arms. I thought they were due to dry skin, but the nurse practitioner who stopped by didn't think so. I was prescribed a corticosteroid cream called triamcinolone acetonide to be applied twice a day.

Chemo #7

Had another chemo on Monday. I think I have to take Ativan for at two days whenever I get dexamethasone. I've noticed that it gives me insomnia for at least two nights, and Ativan helps me sleep.

Pepcid hasn't been working all that well for me. I switched to Prilosec yesterday, and it seems to be working better.

Next Monday will be my last chemo. I have an appointment with my surgeon the same day.

Not much else to report except I'm losing my eyelashes. 👁

Chemo #6

I had my 4th round of Taxol yesterday along with Herceptin and Perjeta. My appointment for blood draw was at 7:10 AM, which meant I had to get up at 5 AM to EMLA cream on my port to numb up the area.

Again I managed to get a private room for my infusion. My appointment started at 8:10. It didn't take long for the pharmacy to prepare my drugs this time. By 9:20 I was hooked up to Perjeta. That took 30 minutes, then another 30 minutes of observation. Herceptin also took 30 minutes. Taxol started at 11:00 and was done an hour later. 

Before being discharged, I had to take two potassium pills because my potassium level was below normal due to diarrhea. The potassium pills were huge! Horse pills! And I have trouble swallowing pills in the first place. The first pill took me only two attempts to swallow. The second pill took four attempts. By that time it had disintegrated, and I was able to add a bit of water to the cup that held it and swallow it. Thank goodness it didn't taste too bitter.

Taking Pepcid twice a day improved my appetite, and I managed to gain a pound since Friday. I was at 97 lbs. yesterday morning. My WBC is below normal. I'm definitely immunocompromised now. My RBC is also below normal, making me anemic. 

My friend Sindhu gave me a ride at 6:30 AM. Cousin Nancy gave me a ride home. Thanks, ladies!

Echocardiogram and Doctor's Visit

Last Friday I had to get another echocardiogram because my treatment can cause permanent heart damage. The tech would make me hold my breath occasionally, and sometimes she'd forget to tell me when I could breathe again. When the test was over, she told me I could hold my breath like a 22-year-old. 😛

I saw my oncologist afterward and complained of fatigue, loss of appetite, and heartburn. I thought she would prescribe something to stimulate my appetite, but she thinks the loss of appetite is due to the heartburn. I would get full after just a few bites, and it was also due to heartburn (bloating?). She told me to take Pepcid twice a day, and if that's not enough, take one in the morning and two in the evening. 

The fatigue is a side effect of chemo and is cumulative, meaning it will get worse with subsequent chemo rounds. Anemia is also making me weak.

I'm down to 96 lbs. I was 114 lbs. before I discovered my tumor.

Chemo #5

Chemo #5 was on Monday. My first appointment is always a blood draw. Two hours before the blood draw, I apply a thick layer of EMLA Cream (lidocaine 2.5% and prilocaine 2.5%) on my port and cover it up with plastic wrap and bandages. It numbs up the area so that I don't feel the Huber needle when it's inserted in my port. I learned in the past that applying the cream 1.5 hours before the blood draw didn't numb the area enough, so I always do it two hours early. The needle is left in my port after the blood draw so that it can be used for my chemo infusion.

About an hour later later, it's time for my infusion. A nursing assistant checks my height (it changes for some patients!) and weight (down to 98 lbs. 😮). Then they take me to an available infusion chair in an open area. The chairs are separated by curtains for privacy. But the Stanford infusion center has a certain number of private rooms available. I've been lucky so far in that I've always been able to get a private room. 

The nursing assistant checks my blood pressure, oxygen and temperature. At some point, an order is placed at the pharmacy for my chemo drug based on my latest height and weight. 

My nurse for the day then arrives and gives me premeds and starts a saline drip. The first two times I got Taxol, I was given three of the premeds intravenously (Pepcid, dexamethasone, Benadryl). Zofran was given to me in pill form. Starting with this third session of Taxol, only Pepcid was given thru the IV and the rest were in pill form. Dexamethasone should be taken with food, but I didn't want to break my fast. I took a chance that Pepcid will take care of any upset stomach, and it did.

The room usually feels cold, and I ask for two blankets. They're quite warm, as if they're fresh out of the dryer. Then I wait. The pharmacy must be very busy because it often takes two hours to get my chemo drugs ready. In the meantime the Benadryl makes me drowsy, and I manage a 20-minute nap.

A side effect of Taxol is peripheral neuropathy. To avoid that side effect, I apply cold packs to my feet and hands as soon as the Taxol infusion begins. You can see in the photo the blue cooler I brought with several cold packs. I also ask for a cup of ice that I chew on. It's supposed to help prevent mouth sores.

The Taxol infusion takes an hour. The Taxol and saline drip makes me pee several times. I have to drag the IV stand with me every time I go to the bathroom. 

When the Taxol is done, the nurse removes the Huber needle from my port and applies a bandage. My first appointment was at 10:20, and I didn't leave until 3:15. That's five hours for basically a one-hour infusion with a lot of waiting in between.

My cousin Nancy gave me a ride this time. I think I'll be okay driving myself for these infusions, but friends insist on giving me a ride, so thanks.