chemo follow up

I saw Dr. R., my chemo doctor, for a follow up this morning.

The chemo nurse took 3 vials of blood to check my counts. She explained that the pain in my back, hips, and legs was from the shot that they gave me to increase my white blood cells. Since bone tissue creates blood cells, the biggest bones in my body were working really hard. No wonder I've been in so much pain. It worked, though. I have more white blood cells in my body than you (or most people) do. Yay!

Dr. R. said "no restrictions" and seemed to think that things were going very well. She felt Lumpy and said that it was softer and that the skin over it was easier to move. Apparently, that's a good sign.

needle count: 15
touch count: 11

this pleases me

I saw my amazing chiropractor today. He's so awesome. I feel like he's a little bit of my therapist, not just for my back. He suggested that I consider cutting out gluten because if I'm sensitive to it, I might have an inflammatory response which might increase my negative side effects from the chemotherapy.

Afterwards, I walked about center city in the gorgeous too-early-for-spring weather. I got myself some groceries to have on hand at work. Then I met with my wonderful surgeon who said that my port was healing well. Dr. L. said that he didn't think that the metal clip, injected to mark the site of the tumor, "stuck", but he also did not seem to think that it would prevent the tumor site from being identified. He prescribed me a topical cream to numb the port area, so that it won't hurt the next time that the chemo nurses inject it. Yay! He offered me more painkillers, but I still have at least a week's worth. I won't get to see him again until June or July, when chemotherapy is completed. Dr. L. said that I could call him anytime with questions or if I needed more medications.

Plus, I found some fun stuff:

• chemo support
• some folks get to clean my place (hopefully next month)!
• delicious soup delivered to my house by a dear friend
• oh, I hope i can have these adventures next year!
• my neighbor doing my laundry and delivering it back
• yoga for cancer patients
• wig shopping this weekend
• free makeup and wig help
• manicure and facials
• 2 fantastic graphic novels (which I got pre-cancer and am lending to my mom) and this

yay!

stupid chemo

I have a hard time telling people when I'm having a hard time because most people have hard times hearing about other people's hard times. I feel upset when I know that I'm creating a situation that is difficult for other people to deal with. I tend to try to help other people process their feelings; I'm a therapist, after all. I can't actually help other people process as I don't have the energy. I'm not in a position to do so.

I went to work today and was in pain. I've been having trouble with muscle cramps and bone aches in the last couple of days following chemo on Thursday. I felt frustrated that my pain was obvious to other people, because it was difficult enough to sit with my own pain, without having to watch other people helplessly watch me. 

I feel cranky and irritable. I'm a little freaked out that I'm entering menopause (because of the chemotherapy). Cancer sucks. Chemo hurts. I probably need to do some painting.

That said, I did have a wonderful weekend of sleeping ridiculous amounts and visiting with my sister and friends. Yesterday, a friend took me to see The Artist (so wonderful). I even had enough energy to go for a walk afterwards and to eat a little, before heading home. Of course, I was so tuckered out by being awake for 10 hours that I fell asleep before 9pm.

I have doctors' appointments tomorrow and Thursday to check the port and my blood counts. 

chemo

Thursday was my first chemo treatment. Since then, things have been kind of a blur. I will try to piece it together.

On Thursday, I was at the office from 11:30 am till almost 7pm. Dr R. examined me and told me about the treatment side effects. I had to wait for an available chemo chair.

Then a nurse injected the port site. It hurt. A lot. I probably would have kicked her if she was in front of me, just from reflexes. She said that it won't hurt as much next time because it would be more healed. I am getting cytoxan, herceptin, and taxotere. The nurses also gave me benedryl and dexamethasone so that I wouldn't be allergic or nauseous. Mostly I slept.  When I woke up, Ken and Nicole were there, which felt good. Ken took me to get pho and I slept for the rest of the night.

I slept most of Friday. I woke up so cold that I was shaking, despite laying in my zero-degree sleeping bag. I put on thermals and another blanket so that I could go back to sleep. My temperature went up to 100.4, so I called the doctor. My neighbor came by and made me tea. Ken brought me soup. I don't remember anything but trying to get comfortable.

I can't speak to anyone else's experience, but chemo, for me, felt like the very worst hangover ever, in the history of the world. A hangover after a night of drinking and fighting in the snow. Everything hurt. I seemed to have mystery bruises, aches, and tender spots everywhere. I felt nauseous and desperately thirsty. I couldn't seem to get warm. I was pretty cranky.

needle count: 14
touch count: 10

telling kids at work

Today, I decided to start telling some of the children who I see in therapy that I have cancer. I wanted to prepare them for changes that we might expect to happen, like more disruptions in their scheduled appointments and changes in my appearance.

The first girl I told is a teenager with lots of struggles with anxiety. I've worked with her for about 2 years and she has made enormous changes. I'm so proud of her efforts. Because she rarely misses sessions, I gave her the option of switching therapists to someone who would be there more consistently, but she said that she'd rather see me as often as we could. She seemed upset about my announcement; I felt bad in sharing. Being a therapist is hard.

Later, I told two siblings whom I've worked with for three years. The older brother said that he'd come in less often. He's doing great anyway, so I was trying to move him toward that kind of schedule already. His sister seemed engaged and matter-of-fact in the conversation. Apparently, she just learned about cancer at school, but she thought that everyone died from it, which lead to more weird conversations. She was very excited about me wearing a wig "because white ladies don't get to wear wigs that much".

port put in

On Friday, I had to get a port put into my body to make it easier for chemotherapy. The port is small device under the surface of my skin, about 2 inches below my right clavicle. The chemo folks will inject it during treatment. They can also take blood from it as well.

We got to the hospital before 9 am to register and answer the same thousand questions for the sixth or seventh time. I felt nervous, but I was trying to focus just on the moments and not on my thoughts or feelings. I don't really remember too much of the day.

The anesthesiologist, Dr. G. had trouble getting the IV in. He used 4 needles and left big bruises on my arm. The hospital's elevators seemed to not work too well; we seemed to have to wait forever for them to go up and down the stairs to surgery. I remember that they had to give me more anesthesia than they thought that I needed.

I woke up with tons of blankets on me in an isolation room (because I'm allergic to latex). Eventually they brought back to the room where I started. It was really great to be met by several friends. I don't remember what we talked about, but it felt so good to see people I recognized.

We left the hospital around 4pm. I slept on and off the rest of the night and most of Saturday.

My chest is sore, but much better today than it was on Friday. It aches when I move my right arm. Lumpy is tender too. It hurts when people hug me, but, otherwise, I feel better today than yesterday.

Needle count: 8
(Touch count is going to stay the same since I wasn't conscious.)

gratitude

Today is the only day this week that I don't have a doctor's appointment. I am grateful for the break. I'm nervous over my procedure on Friday to get the port (for chemo).

I am so happy I have friends who distract me with delicious food and good conversations.
I am so glad for friends who come with me to doctor's appointments.
I am thankful for friends who can listen to all of my frustrations and friends who help me relax.
I am so glad for my family's support.

And for breaks.

Back to Surgery

This morning, Ken and I went to the surgeon's office for my appointment. He discussed the nature of surgery and I suggested that Dr. Rubin had indicated that we should start with chemotherapy instead of surgery.

More interns touched my breast. This is getting completely annoying.

I also got my pathology report and my MRI report.

Some highlights:

• "Pathology report revealed infiltrating ductal carcinoma left breast measuring at least 1.4 cm"


• "Two slightly suspicious lymph nodes in the left axilla"

I am so relieved that there are no other lumps in lefty or in righty. They are otherwise fine!

Also, we are going to meet on Friday and have a huge slew of tests on me. Surgeon will add a port to my chest to keep the needle pricking to a minimum. So far, there have been only 4 needles.

Meet the Chemo Doc

I met the chemotherapy doctor with my friend Emily.

Dr. R. said that she thought Lumpy was "triple positive" and receptive to estrogen, progesterone, and HER2. She explained that that tended to be helpful in using chemotherapy to reduce the size of Lumpy before surgery. She also added that they would have to give me the full mix of medications as well. Dr. R. added that I'd be losing my hair within a month of treatment starting.

Her plan is to start next week on Thursday. Eek!

She also added that I would have treatment for 3 hours straight once every 3 weeks for the next 4 months.

Oh boy!

While we were in the office, a nurse, specializing in helping breast cancer patients, explained the process in more detail and also suggested that I get genetic testing, since this is the 2nd time that I've ever had cancer and I'm only 34.

After this appointment, Emily and I got burgers at South Philly Tap Room. I figured I might not be able to eat them as much for the next few months.


Touch Count: 14

MRI

I had an MRI (with and without color contrast) on my breasts. I had to lie face down with my arms above my head and my breasts pulled between foam boxes for about 45 minutes. It was terribly uncomfortable. The whole process should have taken about an hour total, from check in to check out, except that the staff at Methodist Hospital kept holding up the process.

At first, they would not me check in without having the actual doctor prescription. I called my doctor and he faxed it over immediately.

Then the medical assistant preparing me for the MRI said that they would not do it without having the reports from the previous tests (Ultrasound, Biopsy, etc.). She insisted that I had mammograms, which I didn't. I tried to ask if they could run the test and have my doctors intrepret the films, but she said they couldn't. She also yelled at me that I was doing everything wrong. She added that she had breast cancer last year and couldn't understand why I was making such a big deal about it. I really wanted to hit her.

Finally she left, and the MRI techs brought me back. They asked me to lay down on a platform. The assistant helped me arrange my breasts in foam pockets with my head in place so that I can't move. I had to hold still and they talk to me through the MRI. It's loud rapping and clicking. I found my mind trying to anticipate or create a pattern in the sound, but I can't. The sound made me think of Harrison Burgeron, from the Vonnegut story that no one else seems to have read.

Anyway we were at the hospital for about 4 hours for this whole process. It exhausted me.

Also, Dr. L. told me that my health insurance would not cover the PET Scan and that he'd been on the phone with them to persuade them otherwise. I am angry and frustrated. I feel like my insurance company is preventing my care.

After the MRI, I head to work. I'm awful and can't focus. I keep reading sad websites about wigs and cancer. I am super cranky pants today.
Needle Count: 4
Touch Count: 13

2nd meeting with surgeon

It's my mother's birthday and my parents come to the doctor with me. I worry that they'll be late or that somehow I'll be stressed by their company, but it feels really good to have them there. I feel a little guilty that I am ruining my mother's birthday, but I can't really focus on that too much.

Dr. L. examines me and says that surgery won't be for at least another 2 weeks, due to the bruising from the biopsy. He adds that I'll also receive chemotherapy and radiation, but that we don't know the order yet. We might start with chemo to shrink the tumor or with surgery to get it out. He prescribes me painkillers to help me sleep and schedules me for an MRI the following Monday. He describes the surgery as having 2 incisions: one "smile-shaped" cut on my breast and one in my armpit to remove the sentinel lymph node, to biopsy it see whether the cancer had spread. Yay!

His office schedules me to meet the radiation oncologist and the doctor coordinating my chemotherapy. I was an art therapy intern in the radiation oncology office and it feels strange to be back as a patient. The art therapist comes back to catch up with me as I complete enormous packets of information. The geeky part of my brain is annoyed that my information somehow did not travel across the street. Isn't that what computers are for?

Dr. K. examines me and tells me that I'll probably receive 7 weeks of radiation, which will be the last treatment that I get. She suggests that it will be in the summer (2 weeks till surgery, 4 weeks of recovery, 6 weeks for chemo, 4 weeks of recovery). I am comforted by the timeline. While we're in her office, I let my mother feel Lumpy. I try to joke that it's like when she felt my sister's pregnant belly, but maybe that's too dark for this moment.

After the doctors' appointments, I take my parents to 4th street deli. We eat gigantic ridiculous sandwiches and try to process the day. I go home and sleep for hours.

Touch count: 12