Saturday, March 21, 2015

Chemo Recovery

I feel like I am slowly recovering from what chemo has done to my body.  I am able to get through the day without napping and can get all my stuff around the house/errands done without issue but I am still more tired than normal and have the shortness of breath (which seemed to have gotten better but it now back).

I had a follow up appointment with my medical oncologist yesterday and they took blood to check all my counts.  The hemoglobin continues to be low, which is why I am short of breath.  Usually, this is caused by low iron, but it turns out my iron is totally fine, great in fact.  The doctor was a bit surprised given my vegan diet.  (Go spinach and beans!!!)    So, the low hemoglobin (and white blood cells) is just due to the chemo ravaging my bone marrow.  The 2 courses of action are (1) wait and let the counts come back over the next few months or (2) get a blood transfusion to kick start the recovery.   On Thursday, I'll have a blood transfusion.  I just don't want to wait months to feel better.  I had to run down the street because the dog was getting into someone in the neighbors yard and I thought I was going to have a heart attack!  Hopefully this helps.

On Thursday, I will also get my first Lupron shot. Lupron is what will shut down my ovaries. I will get the shot on a monthly basis.  Many women get it quarterly but my doctor when back to the studies looking at its effectiveness and in the study, the shots were given monthly.  She wants to follow the study for me.  I need to have these shots for the next 5 years (at least) so this might push me to having my 1 functioning ovary removed. We'll see. I'm not rushing into that decision.  I will then start the Letrozole (known as Femara) pill in May.  This is what will prevent the cancer from coming back by preventing the production of estrogen in my body from sources other than the ovaries. (It can't handle estrogen produced by the ovaries which is why we need to shut those down.)   The side effects between both are sweating, headaches, fatigue, hot flashes and joint pain.  Sounds fun, right?

Radiation is going fine. No side effects yet but the doctor expects the skin reaction (sunburn) to kick in soon.  There is also fatigue but I am already tired from chemo so I don't think it will get much worse.

I am trying to get myself back into an exercise routine.  I never was particularly flexible but I guess the PiYo (Pilates/yoga) I did last year had an effect because I definitely can't do as much now as I could then.  I am going to a Yoga class at the hospital today that is specifically for breast patients.  I am excited to get back into a routine!

Thursday, March 12, 2015

Radiation

About 2 weeks ago, Mom and I went to meet with Dr. Lingos, my radiation oncologist to discuss and plan for my radiation treatments.  I had met with her last October and got "mapped" for radiation, as we thought I would not be having chemo.   The mapping involved giving me 4 small blue tattoos, which helps them get you lined up to deliver the radiation.  Luckily, they were able to re-use those tattoos. 

The biggest item for discussion with Dr. Lingos was whether or not we also radiate the lymph nodes (in addition to the breast).   We had planned to do this when chemo wasn't happening to be as aggressive as possible, but since I ended up having chemo, I was hoping to avoid.   Radiating the nodes puts me at higher risk for an incredibly uncomfortable condition called lymphedema.   We discussed and Dr. Lingos believes we definitely should radiate them since my case has not followed the norm and we should continue to be aggressive.  So, we are radiating the nodes...

Other than lymphedema, my big fear with radiation is that the right implant gets messed up and I need surgery (or surgeries) in the future to fix it.   Radiation will tighten the skin in that area, which can cause the implant to become mishapen/harden.   As of now, I have one of the best reconstructions most of my doctors have ever seen (they have ALL commented on it... Thank you Dr. Glatt).   There is not much I can really do to prevent an issue, so I am trying not to worry about it.    Dr. Lingos did recommend massaging the implant and moving it around, so I'll try and remember do that daily.   Whatever happens, happens at this point.

Yesterday, I went to the Cancer Center for my "dry run."  Basically, they showed me around and got me into the radiation machine and positioned me to take some pictures.   Luckily, the treatment only takes about 10 minutes because it is not the most comfortable position to be in - lying on my back with my hands above my head.  I feel like my right hand immediately falls asleep when I get it into position!  The first treatment was today and was easy.  Not sure how long before my skins starts to react (it will get red/sunburned and blister).  The other side effect will be fatigue, but I am already tired from the chemo.   One down, 27 to 32 to go.  (Dr. Lingos hasn't decided if I'll have 28 or 33 treatments in total.)

As for other chemo side effects, I still have the neuropathy in my fingers and toes.  It is annoying but not too terribly uncomfortable.  Just imagine feeling like your extremities are falling asleep all the time.  I am hoping the sensation will dull with time and does not become permanent!

Monday, March 9, 2015

Hair

My hair should be starting to grow back, now that chemo is over.  The whole hair loss process has been interesting so a few observations...
  • Despite losing hair on most parts of my body, I still have a significant amount of arm hair.   What's so special about arm hair???
  • I have maintained a small amount of stubble on my head throughout the process.  Everyone says is looks really light.  If it comes back light, it better be blonde light and not GREY/WHITE light.   Craig has had an ever increasing amount of white hair since I met him and I have always made fun of him.  He'd have way too much fun if my hair comes back grey!
  • My eyebrows have definitely thinned.  For once in my life having bushy eyebrows is working in my favor.
  • I really wish my leg, armpit and old lady facial hair don't grow back.  (With the radiation, it is likely the armpit hair won't come back on my right side.)  
  •  My upper lashes are mostly gone and the lower are thin.  I miss my eyelashes.   Hopefully they'll grow back quickly.
  • I lost all my nose hair (early on) which means my nose has been running for 3.5 months.
Overall, the hair loss process has not been as awful as I thought it would be.  It has been a cold winter to be bald but luckily I have lots of warm winter hats!   I am hoping by Hawaii that I have enough hair on my head that it looks like short haircut rather than post-chemo hair.

Tuesday, March 3, 2015

Port is out!

My port was successfully removed today and I could not be happier.  It went smoothly although I ended up at the hospital for longer than I had anticipated.

I arrived at 10:15 which was the time the told me to be there.  I had never asked what time the actual procedure was and did so after they checked me in and took my vitals at about 10:20.  The procedure was not until 12:00pm AND the surgeon had added another patient in the morning so it was likely to start late.  I was not happy and had not really prepared to wait that long.  I was sent back to the waiting room to hang out for what turned out to be the next 90 minutes.  The time actually passed quickly.  They took be back into pre-op at noon.

Since I had opted for local anesthesia, I did not need an IV. Basically, I just had to change into a gown in pre-op.  They took me into the operating room at about 12:45pm.  When I met with the surgeons PA last week,  he made a comment that the only bad thing about local anesthesia was that I would have to listen to his and the surgeon's jokes.  I thought he was kidding but it turns out he wasn't.  The surgeon literally has a nurse read from a joke book during the procedure. (I assume only when the patient is awake...).  A nurse named Linda was assigned that task. She read a few terrible jokes while I was getting numbed up.  (The lidocaine shots were not particularly pleasant.). The surgeon then left the room while I was getting numb and Linda and I started to chat.  She was lovely, asking me about the kids.  Turns out she lives in the next town over from us.  When the surgeon came back, I told him I preferred to chat with Linda rather than hear bad jokes. Also, I figured I should not be laughing and moving while he had a scalpel near my carotid artery!!

They got me all draped and started removing the port.  I felt some pressure but no pain.  I was afraid I would feel them pulling out the tube that went into my vein but I felt nothing.  (I did smell something nasty.  Not sure what it was and I didn't ask.). I think it took about 10 minutes and it was done.  I am SO happy I did not have anesthesia for the procedure as it really was no big deal and I now don't have to deal with waiting for the anesthesia to totally wear off.   It seems to take longer and longer each time.

They wheeled me back to recovery around 1:15pm.  I had a quick drink, got dressed and was on my way.  There weren't any post-surgical instructions (other than the surgeon telling me to take Tylenol for any pain) and I walked myself out and drove home (stopping off at Target to pick up some random stuff and a coffee).  I took Emily to dance class.  I am a little sore and tired so I will head to bed early. I am glad this is done.

Tomorrow marks the 4th anniversary of my bilateral mastectomy.  That was definitely the most invasive of all the surgeries I have had in the last 4 years.  Today was the 7th surgery and the easiest one.  I feel a sense of closure in my cancer surgery process. I like that. It helps convince me that this is my ONE and ONLY recurrence!!!

Monday, March 2, 2015

Port eviction date TOMORROW






Tomorrow, that ugly bump in my chest will be removed, hopefully giving me plenty of time for the scar to fade before bathing suit season and our HAWAII trip (which starts in 3 months and 18 days).   At the end of the day, I am very thankful to have had the port as it did make chemo much easier and my veins are still in great shape.  Julie, Craig and others... you were right!   It is important for my veins to still be good since after radiation I will only be able to have blood drawn from my left arm.  More on that in a later post...   Other than a few weeks in January, when the port really bothered me (it kind of burned), I have hardly noticed its presence.  Well, except for when I get dressed every day.  Only certain tops cover it up so I have to be careful about what I wear because no one wants to see my ugly port!

The procedure to remove it is quite simple.  It will only take about 10 minutes and will be done under local anesthesia. I am a bit freaked out about being awake for the removal but I am finding the anesthesia hangover lasts longer and longer each time I have it, so happy to avoid it.    I can eat in the morning and drive myself to and from the procedure.  Say a little prayer it goes smoothly!

I am very happy that my oncologist feels confident that I won't need the port anymore and can have it removed before radiation starts!