Monday, July 16, 2018

Number 5 is a go

Side Effects from Round 4 were rough again.  I'm not sure if it was just the cumulative effect or if it was because of the blood clot and the addition of Xarelto.  I was able to stay ahead of most of the gastric issues but fatigue, appetite and bone/muscle pain issues were much worse this time.

It took at least 14 days to recover and I never really fully recovered.  My arm swelling came back over the weekend just as I was starting to feel better so my oncologist wanted a repeat ultrasound and thankfully the jugular vein clot has totally resolved with the Xarelto.  I'll remain on it for at least 3 months but the good news today from my oncologist is that he wants the port removed shortly after I finish chemo.  I'm thrilled because when I was receiving the chemo for lymphoma my doctor wanted the port to remain for a least 6 months following treatment.

I also got scheduled for my appointment with the radiation oncologist for August 2nd.  At that appointment I'll get a better idea of how much radiation I'll be receiving.  I'm hoping to be done with radiation by Canadian Thanksgiving.

Tuesday, June 26, 2018

Ready for Round #4

Wow! Those 21 days passed quickly.  I think that is both a good sign and a sign I had a very busy 21 days. Unfortunately it started with having to say goodbye to Duffy Duff.  He had a great life and was an amazing companion.  Absolutely could have made an excellent therapy dog.

Then we were busy moving Zach and Anastasia to Chicago so they can begin adulting full time.  I had never been to Chicago for a visit (just for flights and one wedding 20+ years ago). I stayed for 4 days and loved the city and their neighborhood.  We ended my visit with a trip to see Hamilton.  Totally worth it in my view.

When I landed in DTW my cousin Jennifer was waiting to greet me.  She had flown in from SLC for her father's final memorial.  He passed from pancreatic cancer in March.  We had a lovely couple days catching up and just spending girl time together, watching a silly movie and eating great food.
A trip to Kenton, Ohio for my uncle's memorial allowed me to see a lot family from both my mom's and dad's sides of family.

Then I finally returned to Canada.  It seemed liked it had been forever although it had only been 2 weeks. It was actually harder to deal with Duffy's absence there.  But I collected his belongings and donated them to a local animal shelter.

Notice how this post has had lots of activity and little discussion for side effects.  This round really had very minimal side effects.  Fatigue, tasting issues and my left arm has been battling edema. I'll be having an ultrasound this week to rule out DVT in that arm.  6/27 UPDATE Ultrasound did show a Vein Thrombosis but in the jugular not arm.  So I'll be on a blood thinner,  Xarelto and hopefully that will take care of it.

I think I have most of the preventative meds scheduled well.  For those who come across my blog undergoing TCH.  Here is a what I've been having good luck using. Prior to treatment days I'll indicate with a -Day in parentheses. 

  • Day 17 (-4) -I start the Activia Yogurt ( I do take a daily probiotic as well) I continue the yogurt through Day 5 if I'm tolerating it
  • Day 18 (-3)  Prunes ( I do 3 a day until about Day 5 or 6)
  • Day 19 (-2) Begin the Hydration increase ( I try to do 2.5-3 liters of water a day until Day 3)
  • Day 20 (-1) Senokot S 1 tablet daily. I know when to stop. 😉
  • Day 20 (-1) Start the Prilosec OTC 
  • Day 21 (0) My steroids begin day before treatment.   
  • Day 1 - Treatment day - Snack on ice chips during Taxotere infusion (my mouth sores were minimal after starting this.
  • Also Days 1- 5 Gargle/Swish with 1 TBS baking soda dissolved in 8 ounces of warm water after eating anything.  I carry a small bottle of Biotene so I can do this if I eat out during those days as well.
  • Days 1- 3 I start the Zofran/Compazine for nausea at 12 hours post preMeds. I don't miss a dose alternating the two meds and even setting an alarm to wake for them.
  • For me bone pain from the nuelasta is the worst around days 4-6.  I've been finding relief with warm soaks in Epsom salt.  I take extra strength Tylenol during the day and take Claritan during the week of treatment.  On my worst nights I have Tylenol with Codeine.  Most rounds I used it on two nights to sleep.
  • Acid is still an issues with the Prilosec on days 5-9 so if it gets bad I supplement with extra strength Pepcid AC or Maalox. 
  • As for fatigue - I try to walk at least 4,000 steps even on my bad days and work in a nap.
I'm looking forward to round #4.  My friend Kari and her daughter Lila drove up from Indiana to keep me company for a few days.  And then GM shutdown starts so Gary will be joining me for a few weeks in Michigan.  Before we know it I'll be preparing for Round #5.         

Tuesday, June 5, 2018

Round #3 - Halfway to Chemo Finish

I'm feeling prepared for Round #3.  Round #2 was definitely better than Round #1 but also a little different.  More like a roller coaster.  I felt the same crash on day 4 but recovered on day 5 only to crash again with horrible gastric acid issues on Day 6.  Felt pretty puny until about day 9.

Thankfully had a good discussion with Medical Oncologist about those issues.  I said I'm scared I'm going to leave chemo this time with an awful ulcer.  He's response.  "Yes that happens sometimes." Gee thanks Doc.  So game plan now is daily Prilosec for the 10-14 days and supplement with Maalox or Pepcid.  Anything to keep acid down.  I warned him I have tickets to Hamilton on Day 9 so I better feel good.  Now he's got an ulcer. 😉

Thought I might write a little bit about why at Stage 1 breast cancer I am having chemo.  Seems appropriate when the news is covering a study that is giving hope to many to avoid chemo for early stage breast cancer.

Breast cancer isn't just one type of cancer.  You'd think after years of the Pink October most of us would know that but the Pink really isn't about education it's all about making money.

My tumor has several characteristics that demonstrate it was aggressive in nature.  Personally now that I've had two aggressive cancers, I'm starting to question all of the evenings chanting Be Aggressive - Be -Be Aggressive B-E-A-GG-RESS-IVE on sidelines. Obviously my cells were listening.

First of all my Tumor Grade was 3 - which means my cells looked really f'd up under a microscope.

Second my Ki67 markers were extremely high Ki-67. The more positive cells there are, the more quickly they are dividing and forming new cells. In breast cancer, a result of less than 10% is considered low, 10-20% borderline, and high if more than 20%. My % was 62.

Finally, my tumor was (notice I use "was" thanks to clear margins and no lymph node involvement) ER-,PR- and HER2+ which means tumor was not hormone receptor positive but HER2+ which is a protein that can be treated successfully with targeted therapy.

Even if I had chosen to do a mastectomy I would have still been required to do chemo so for me breast conserving surgery (lumpectomy) + chemo + radiation is the recommended option and one I was confident in choosing. 

Tuesday, May 15, 2018

Ready for Round #2 and Reflections on Round 1

Bonus of having so many amazing friends willing to act as my chemo buddy ....each round has me waking in a good mood because even though I will spend 4+ hours being poisoned I get to spend time with women I love and am blessed to have in my life.

Today my BFF Lisa will be my support and as a reward I will introduce her to one of my all time favorite movies "Pleasantville." My mind is still blown she's never seen this modern day classic. Treatment should be faster this time. 🤞🏻

I am hoping for a better time following this round.  Last round I crashed on Day 4 and had a really rough weekend.  Which reminded me how we should always show compassion to people we meet out in public.  I made it to Zach's graduation that Saturday ( I wouldn't miss it) but the night before I was so sick. Thanks to Zofran, Imodium and Codeine I made it and was able to enjoy the company.  But if you met me or saw the pictures you'd never think that lady packed a change of clothes because she is so worried about having an accident.  The diarrhea lasted for 7 days and on the following Thursday I ended up in the ER with a fever of 102.  Still not 100% sure what it was.  It could have been a neutropenic fever (my neutrophils were dangerously low- which is normal with this type of chemo) but I'm convinced it was some type of gastric bacterial infection because 2 doses of Flagyl and the diarrhea stopped.  Again I didn't want to miss Shelby's Indy-Mini so I bought adult diapers and we hit the road like a scorned astronaut.

Just a little reminder there are people dealing with shit all around you.  Maybe they just choose to look on the sunny side of the street.  That's my philosophy.  And it doesn't mean I'm some amazing warrior.  I do have bad days. It's just that I came to cancer after experiencing some real shit.  When it hit me on Shelby's birthday that she's the same age I was when my dad died by suicide,  I knew I'd do whatever it takes to stay in my children's lives.  Losing someone to mental illness leaves scars that never heal.  My dad has been gone 25 years.  I feel the scars but I don't pick at them anymore.  I hope that one day treatment for mental illness will have as many options and support as cancer.

Wednesday, April 25, 2018

Treatment Plan and Chemo2.0 Round 1 update

So the chemo/targeted therapy I'll be receiving this time is TCH (Taxotere, Carboplatin and Herceptin)
It is one of the standards of care for Hormone Receptor Negative, HER2 + tumors.

It also allows me to avoid additional Adriamycin. That evil red devil has a lifetime maximum dosage due to irreversible heart damage.  Several of the drugs in my regimen can also cause heart issues but thankfully they are reversible.  Because of that I once again had a MUGA heart scan prior to starting treatment and will have those repeated every 3 months.  If numbers decline too much, treatment will be delayed so that heart can improve.  I've read a lot about the issues and as such have increased my CoQ10 (which I've been taking since mom's open heart surgery).

First round of chemo took a little longer than I had hoped but that was partly due to some issues with my Medi-Port.  My nurse's educated guess was probably residual scar tissue from my previous chemo. The solution was easy enough I was placed on a pump and the only inconvenience was unplugging it every time I needed to use the washroom.  Thankfully Chemo Buddy Lorrie is excellent at  plug work.

I really noticed next to nothing with the Taxotere and Carboplatin (the two chemo drugs).  When it came time to push the Herceptin (the targeted monoclonal antibody) the first infusion is slowed down (much like my initial Rituxan) I noticed some muscle aches and flushed a little bit.

The best news from this go at Chemo is the biomedical engineering advancement with Neulasta.  Thank goodness my insurance is covering the Neulasta OnPro which is a medial device that will give me the Neulasta infusion in the comfort of my own home.  So far it seems to be working as advertised.  A little green light lets me know the connection is still good.  (I had it placed on belly because I'm a side sleeper and back of arm was other option)

Side effects are seeming pretty good today.  Although being an advanced patient, I've been using lots of lessons learned before.  I started the Zofran 12 hours post pre-meds.  I still woke around 2 am feeling nauseous so I supplemented with the Compazine.  Better safe than sorry I think for the next few days.  The good news is I haven't noticed the headache I had with the Zofran last time.

Goal for today.  Lots of hydration, fiber and rest and relaxation.

Tuesday, April 24, 2018

Here we go again. Cancer 2.0

I've been struggling with deciding whether or not to continue with this blog now that I have been diagnosed with a second cancer.  But this past weekend I received a wonderful message from a fellow Lymphoma fighter and I'm going to take that as a sign that yes indeed this is the right place to blog about my new diagnosis.  Especially since I've had a hard time finding other cancer survivors in my position.

I'll keep this post brief as today I actually head back to Genesys Hurley Cancer Institute for my first round of chemo.

Here's the timeline:

Jan 30 - I was getting a pre-vacation bikini wax (TMI?) my technician noticed my lymphoma survivor tattoo and we started discussing cancer.  Her mother had recently passed from a melanoma.  I told her my story of craving sweets the summer before my lymphoma diagnosis.  When I got home that night I realized I had been eating more sweets (afternoon chocolate with my coffee).  So I did a breast self exam and low and behold I found a lump.  We were leaving on vacation so tried to put in the back of my mind, knowing I'd call for appointment as so as I returned.

Feb 15 - my GP wanted to see me before ordering a Diagnostic Mammogram.  She felt the same lump and scheduled a Mammogram with Diagnostic Ultra Sound for the next day.

Feb 16- Mammogram and Ultra Sound confirmed lump and we got ready to schedule Biopsy.  (I'm now splitting time between Canada and Michigan so scheduling has been interesting this time around)

March 1 - Biopsy (unlike last time this one was not vacuum assisted I guess it is used less now)

March 5 - Diagnosis Invasive Ductal Carcinoma Grade 3

March 9 - Bless her heart my favorite breast surgeon was able to get me in asap.  Linsey Gold is amazing!  Of course she remembered me, she's only found two lymphomas in the breast.   At that visit I was given more information about my tumor.  Small only 1.9 cm but at that point the markers where indication Triple Negative Breast Cancer.  Which meant Chemo would be necessary no matter what.  Her suggested treatment was a lumpectomy, chemo and radiation.    With my 50th birthday just about a month away, Hubby and I had a European cruise/vacation scheduled for Easter Week.  I did not want to miss it but also did not want to delay trip.  This amazing surgeon squeezed me in for surgery the following Friday.  That way I'd be at Day 14 post surgery for our trip and Chemo really wouldn't be delayed as they usually wait for surgery to heal before scheduling.

March 14 - I had appointments at the cancer institute with Radiation Oncologist and my new oncologist (Dr Black has retired).  Good news came that day follow-up testing on my tumor (FISH) indicated that I qualified for HER2+ so no longer considered triple negative.  There is a target therapy called Herceptin that has good results with HER2+ tumors.  My new oncologist agreed I should avoid chemo containing Adriamycin since I've had close to lifetime amount.  So my new treatment will be TCH (I'll do a post on that maybe from chemo chair today).

March 16 - I had my lumpectomy at Troy -Beaumount.  Pre-op nurse there joked that "Girl it's like you've been struck by lightning twice". Yes indeed I'm super special.😜😜😜.  Procedure was simple and honestly not too painful.  I only used Codeine for the first day post op.  Issues from the sentinel node biopsy caused more discomfort than the lumpectomy.  More strange tingling weird numbness kind of issues.

March 19 - Was a good news bad news day.  My uncle passed from Pancreatic Cancer (truly one of the most vicious cancers) but I received lots of good news from the lumpectomy.  Tumor was indeed only 1.9cm and all margins came back clear.  None of the 6 lymph nodes showed signs of breast cancer (they did look like lymphoma nodes but both doctors agree that is probably leftover from previous cancer) The tumor confirmed at ER- PR- HER2+.  I had also completed the genetic testing for BRCA and it returned as Negative.  Great news for a mother of a daughter and several adorable nieces.

March 29-April 7 I had an amazing European Vacation including a cruise on the brand spanking new Symphony of the Seas.

Restored following the trip I was ready to handle two busy weeks of Dr appts and more testing.
MUGA, Port placement and now I'm ready to kick some cancer ass once again.

Monday, June 6, 2011

My Aunt Flo Returns

This probably will be considered as a TMI post but inquiring minds might want to know.

My Aunt Flo has returned after a 7 month absence.  I had actually resigned myself to thinking this chemo-induced menopause was going to become permanent menopause.  At my age, I figured my ovaries were more than happy to hang up the "Gone Fishing" sign and just enjoy retirement.  I guess they decided to reject the early buy-out offered by R-CHOP and plan to work a few more years.