A Night Stand Tableau

So, I rolled over this morning and was greeted by this scene and this is when it hit me - I'm sick. A person's night stand is an excellent window into their life at a point in time. My husband, for example, is an eternal optimist. I know this, because he always has at least 6 books on his night stand that he intends to read, but has only about 10 minutes a day to read them. I am sick. I know this because when I awoke this morning (I sleep on a platform bed which makes me eye level with my night stand) looking back at me was a row of perscription bottles, a box of tissues, Overnight Lip Therapy, saline spray, a bottle of water, a bottle of Advil and a bottle of Tyelnol and a container of Sunsweet Ones - individually wrapped prunes. Of course, I also have 2 containers of very nice lotion - rose for my hands and lavendar for my body, so it's not totally a medicine cabinet, but it is undeniable proof that I'm sick. I haven't really considered myself to be sick throughout this process. First I had surgeries, you have to recover from them, but that's not the same as being sick. I had 5 weeks of recovery in between, when I felt pretty good - I had books on my night stand then too. But now, it appears that I'm sick and have to own up to it, at least until I can figure out how to keep all this within reach, but not on my night stand.

What's on your night stand?

Oh, my nose!

When I was at the Cancer Center the other day for treatment, I mentioned that I was having trouble sleeping which really isn't anything new, but I thought maybe I could get some help. The nurse suggested that I try using Benadryl as an option. I had occassionaly used this in the past, so I thought I'd give it a try. Yeah, that was a mistake! I took 2 Benadryl 2 days ago and my poor little nose hasn't been the same since. Benadryl clears up a runny nose - I didn't really have a runny nose, so my normal nose (which, lets not forget has been subject to the effects of chemotherapy) got extra-dry and began to bleed. So, I am now without the option of Benadryl-induced sleep and have become addicted to my nasal saline spray.

Herceptin Treatment #2

No photo shoot at this one....forgot the camera. My first weekly Herceptin treatment could have gone just a bit smoother, but then again, if there was no drama associated with it, I would have questioned the event! When Charlie and I arrived at Oncology at 8:50, there was a line to check in and barely a chair in the waiting area. Weigh in (lost a little) and blood pressure check in, and it was off to Chemo Pod #3 for the morning. I had a great location. The only chair in the pod with a window view and the chair was turned to face the window instead of the other patients. I'm trying to figure out how I can reserve the location for the next 3 months! Had a successful IV insertion, but there was a problem with my IV tree and that had to be switched out, so that the saline could be started. I shared my bone pain tale with the nurse and learned the reason - my white blood cell count was 37,000 - a typical count would be between 5,000 and 10,000 - so clearly my bones had been busy! The pharmacist delivered the Herceptin and I was promptly hooked up for my half hour drip. Charlie went to get coffee and I thought we'd be ready to leave by the time he got back. Not so fast.....come to find out, for about 45 minutes the Herceptin wasn't actually dripping after all, so the drip didn't start until Charlie came back with the cofee. We finally left at about 12:30. So that's 3.5 hours for a 1/2 drip every Wednesday for the next 3 months and then once every 3 weeks for the next 9 months.....of course, the good news is that chemotherapy patients have free parking - something which thrills my husband to no end. For months he's been asking at every department at the hospital if they validate.

Chemotherapy Treatment #1 Side Effects

So far, I have experienced very limited chemotherapy side effects. I had no real naseau, thanks to the great drugs I was given, but did have some quesiness and heartburn. I have discovered I can no longer tolerate foods with tomato - does that mean I won't be able to have a pizza until June??? Yikes! Once I cut out the tomato, my heart burn pretty much disappeared. I'm working with Instant Breakfasts for breakfast and dinner and trying for some solid food at lunchtime. I have a slight metallic taste in my mouth and my sense of taste has pretty much disappeared except for very strong flavors - I'm suddenly a peppermint patty fan. This morning I discovered if I put a layer of honey under the layer of peanut butter, I can get down some high-fiber toast.

The Herceptin (which I receive weekly) produces flu-like symptoms - sore throat and neck, slight ear ache.

Effects of Neulasta Shot

I did experience quite a bit of pain from the Neulasta injection I received the day after chemotherapy. Neulasta stimulates bone marrow to increase production of white blood cells which can cause pain in the "long bones", and in my case was quite painful. I was leary of taking additional medications, so I although I did take some Tylenol, I waited until the pain was close to unbearable. I found that baths helped and on Saturday took two! I now know that I should have taken Advil (3-4 of them) around the clock and could have avoided much of my discomfort. Lesson learned: my tendancy to tough it out will not serve me well during this experience. Most of this pain has passed, although I seem to be having trouble with pain in my feet during the night - last night was very painful.

Chemotherapy Treatment #1

Here I am at my first chemotherapy treatment. I arrived at 9:00 am and didn't leave until 4:30. Upon arrival, the IV is inserted and a blood sample taken. Next up is a meeting with the doctor and a review of the lab results. Then it's back to the "chemo pod" to await the on-demand mixing of my toxins by the pharmacist. Pop back a couple of Benadryl and Tylenol and I'm ready. The first bag is an anti-naseau medication, and then I'm surprised as the oncology nurse dons a hazard coverall to change my medication - that doesn't really leave you with a comfortable feeling. The chairs are comfortable enough and once Charlie left at about 1:30, I put on my ipod and slept for a few hours. The remaining treatments will be one hour shorter as the first Herceptin treatment is a larger dose than subsequent ones.

Pathology

Cancer:

My cancer is invasive, Stage 1 and Grade 3. This means that it started to break through normal breast tissue barriers and invade surrounding areas, Stage 1 means the tumor was small (1.6 cm) which usually means a better outcome, but Grade 3 is the highest grade of cancer which suggests a faster growing cancer that's more likely to spread. My cancer is also HER2-positive. This type of cancer tends to grow faster and is more likely to recur than HER2-negative cancer. The cancer is ER and PR Positive, which means the cancer is receptive to hormone-blocking medications to slow its growth.

Treatment:

The current plan is a 3 prong approach consisting of chemothepy (four, three-week cycles); Immunotherapy (Herceptin) for the HER2-Positive (administered weekly intravenously for 1 year) and a yet to be determined hormone-blocker for a long period of time - up to 5 years or more.

By taking this combination of drugs, I will reduce my risk of relapse (relapse is defined as new breast cancer (30%) or spread (70%)) from 32% to 5% and the risk of not surviving from 13% to 3%.

Surgeries

When I arrived at my surgeon's office for my diagnosis, (btw my husband was away on a business trip in Texas and I was alone) he had already made arrangements for my surgery, January 17th. I found my lump on December 25th, received my diagnosis on January 9th and had a surgery date for January 17th. Talk about head spinning. The recommendation was for a lumpectomy, which I agreed and the thought was I would then have 6 weeks of radiation. Aha, this was not to be. During my lumpectomy, another tumor was found behind the one that I had discovered, along with another "area of cancer" and my sentinel node tested positive as well, so I had an axillary dissection. When I awoke after my surgery, I found that it wasn't the 2.5 hour surgery I had expected, but 5 hours and I was staying overnight. I went home the next day with bandages and a drainage tube. When I returned to the surgeon's office the next week for a follow up and to have my tube removed I received the news that my margins weren't clean and my surgeon recommended an excision for the next week, he had already scheduled the operating room. The next day my surgeon called and told me he had brought my case to the tumor board and they had recommended I undergo a breast MRI prior to the excision. The MRI was scheduled for Sunday morning. When I arrived at the appointment time, I learned an IV was necessary and they initially told me I would have to put my arms over my head (impossible due to surgery). After six unsuccessful tries by 2 IV nurses, I was sent home with a return date for Tuesday evening. On Tuesday I did have a successful MRI and on Wednesday afternoon the surgeon called to say the recommendation had changed to mastectomy and he would see me tomorrow. Yes, less than 24 hours notice for the loss of a breast - actually a blessing. I had my mastectomy at 12:30 and was home by 6:00 pm the next night - complete with yet another draingage tube and a chest full of bandages.

Discovery and Diagnosis

I found the lump in my breast on December 25 - yes, that is correct, Christmas. Ladies, BSE on your schedule whether it's a holiday or not. Trust me, it can save your life! I saw my primary care physician on December 31 and could tell by her non-commitment that it didn't look good. Her office made an appointment with a surgeon for me on January 23rd, with the agreement that they would try to find something sooner - that being too long to wait. On January 2nd the surgeon's office called with an opening and I went that day for my biopsy. The surgeon did the biopsy and an ultrasound and felt that the small lump (size of a lima bean) that I had found was what there was. His words were "it has some characteristics of a cyst" but he didn't sound very convincing. The nurse said it would take about a week for results and they'd call me, the doctor said I should go ahead and make an appointment for the next week - again, not a positive feeling. The next week, the diagnosis was, of course, breast cancer.