Ophthalmologist

I saw an ophthalmologist today. After my chemo ended three months ago, I started getting lots of styes. It got better after a while, but now it's not improving at all. I was hoping I could get something to get rid of the styes, but there's nothing that will work. The doctor said the styes will go away in 6 to 9 months. 😕

It doesn't look too obvious in the photo, but there are several styes in my eye. I keep accidentally poking the large one. There are not as many styes in the other eye, and they're a lot smaller. Incidentally, my eyebrows have filled out, but my eyelashes are still fairly short.

Another reason for visiting an ophthalmologist was to confirm that my tear ducts are not blocked due to my chemo treatment. To test it, the doctor picked up a syringe with a needle. The needle had a blunt tip, but as it got closer and closer to my eye, I was 😧. He didn't explain what he was about to do, and I was afraid to ask. I believe he inserted the needle into the punctum (the hole in the corner of the eyelid where tears drain out) and flushed it with saline. I let him know when I felt the saline in the back of my throat. He pulled out the needle, then he did the other eye. It didn't hurt, but it was a bit scary.

Anyway, it's good to know that my tear ducts are not blocked. A patient in my support group had this problem, and she had to have stents inserted in her puncta under general anesthesia.

Ultrasound Follow-up

Back in November, Stanford found a tumor in my other breast. It turned out to be a second fibroadenoma that I've had since at least 2013 and that PAMF missed, thinking it was part of the first fibroadenoma. Stanford recommended a follow-up ultrasound in six months, and that's what I had today. Radiologist says there's no change in the tumor, and I can resume regular screening.

Shoulder Therapy

I had a physical therapy session this morning for my shoulder. It had been three weeks since my previous session. I was on the waiting list the last two weeks but never got called. Apparently the staff is extremely busy and doesn't have time to call people on the waiting list when there's a cancellation. 

Raising my arm forward is much better although not quite at pre-surgery level. But when raising my arm sideways, I can't go past shoulder level. The therapist Laurie says the cording in my underarm is gone (AWS or axillary web syndrome complication due to surgery). But the limited sideways movement is due to my frozen shoulder. Even before surgery I could not raise my arm sideways above shoulder level.

Laurie massaged and did some intense stretching of my shoulder. Ow ow ow. She sent me home with five exercises to do, some of which I had done before for my shoulder before surgery. I have confirmed appointments the next three weeks. No waiting list this time.

In the afternoon I went to CVS to get my second shingles shot. The first one was back in November. I held off on getting the second dose while I was on chemo. The shot was quite painful. I iced my arm when I got home and also took ibuprofen. I hope I don't experience other side effects tomorrow.

Dentist

Had my 6-month cleaning and check-up today. My dentist recommended coming back in three months because chemo can thicken saliva and cause cavities. She said to sip water frequently to moisten my mouth, something I already do. She also prescribed a toothpaste with prescription-strength fluoride to prevent cavities.

I have an appointment every day this week: dentist, physical therapy, ultrasound, opthalmologist, oncologist, and infusion.

Fever

Last night I was feeling feverish, so I checked my temperature -- 99.6. Just a slight fever, but I wasn't feeling well, had body aches, felt tired and sleepy, and had the slight diarrhea. I went to bed early and was fine this morning. Well, except for the occasional slight diarrhea.  I think I will continue to have it till my infusions are done in February.

This was the first time I used my thermometer since I started cancer treatment. Even though it's milder than regular chemo, T-DM1 still has many side effects. These are the most common:

• tiredness/fatigue
• nausea
• bone and joint pain
• muscle pain
• low blood platelet count
• headache
• constipation or diarrhea
• nerve damage
• low red blood cell count
• low potassium levels

I'll have to remember to mention my symptoms to my doctor at my next appointment.

In other news, I've been doing my physical therapy exercises and am seeing some improvement. I got a call today from radiology about scheduling a planning session, but I have to be able to raise my arm above my head, and I'm still a long ways away from that.

My hair continues to grow and is about half an inch long. My eyebrows and eyelashes are filling out. But I continue to get many styes. I also have some swelling called chalazion. At least it's stopped hurting.

T-DM1

I saw my oncologist, Dr. Caswell-Jin, on Friday. She had presented my case to the tumor board. They agreed that even though there are still 1% cancer cells in my breast tissue, I otherwise had good response to the chemo and don't need additional cycles. Instead she switched me from Herceptin and Perjeta to T-DM1.

T-DM1 (brand name Kadcyla) is a combination of Herceptin (trastuzumab) and a chemo drug. Side effects should be milder than from regular chemo. I will receive T-DM1 every three weeks for 14 cycles. My last infusion will be on February 4, two month longer than if I had stayed on Herceptin and Perjeta.

I had my first infusion Friday and was given 16 mg of Zofran for nausea. A woman in my support group got bad neuropathy from T-DM1. So I brought ice packs with me to use on my hands and feet to ward off neuropathy. I've experienced no other side effects so far.

Axillary Web Syndrome

I had an appointment this afternoon at PAMF with the physical therapist who worked on my frozen shoulder, Laurie Pepin. Looks like I have axillary web syndrome. I definitely see cording under my arm. It feels so tight when I try to raise my arm. I can't raise it above shoulder level. It's also painful, although the pain has eased up recently.

Laurie did therapeutic massage under my arm. She showed me two exercises and a massage I can do at home. I have appointments to see her weekly for the next few weeks, although I'm on the waiting list for the next two weeks. But because Laurie works exclusively with cancer patients who sometimes don't feel well enough for their appointment, she gets one cancellation per day, and I expect I'll be able to get off the waiting list. 

Also this afternoon I had an appointment at Stanford for an echocardiogram. It was a limited test and took only 10 minutes. The test usually takes 30+ minutes. This is my third echocardiogram. I get one every three months because the drugs I'm on can damage my heart.