11/27/13 - 1st Herceptin Only Infusion


Monday I had my first Herceptin only infusion. I used to think that bad traffic was a precursor for a horrible infusion, but now I've changed my mind. Traffic was terrific yesterday. So terrific that we arrived almost an hour early. My appointment was for 2:00 p.m. and they actually called me in at 1:30 p.m.  I was feeling pretty chipper and didn't even complain when I didn't get my favorite nurse. BAD MISTAKE - I should have complained, screamed and jumped up and down. Hmmmmm, oh wait - I'm not capable of jumping up and down - oh well, you all get the picture.  The nurse came over to my tiny cubicle. She looked nice enough and even seemed to know what she was doing. She started my line and of course she didn't get in right away. What is it with nurses moving the needle around until they hit the vein? I knew right away it wasn't going to work, so I asked her to take it out and try again. It seems she knew better and kept at it, finally hitting the vein. By the time she got in

First Attempt
Second Attempt

Bruise Left From Three Weeks Ago
I was already in pain. I kept the line in for around 10 minutes hoping it wouldn't hurt as much as it did, but I knew I couldn't get infused with the way it was feeling. So Bud called over the move the needle around till I hit the vein nurse and we asked her to take it out. Now let me make this clear, I'd much rather be stuck twice than have them hunt around. Once the needle was out, I asked for my favorite nurse. I was no longer chipper and I decided being grouchy serves my purpose much better. Being nice gets you nowhere in the infusion room. My favorite nurse, Christine is an angel. She went to my other arm and got right in with no problems. Why can't they all be like that? My Herceptin bag showed up around 2:15 p.m. and they started the infusion. Forty-five minutes later we were out of there.



I don't anticipate any side effects because I'm no longer on the yucky stuff. I am feeling fatigued but I'm sure that's leftover from the chemo. I'll check in before my surgery on Dec. 4th. I'll also start posting hair pictures so you can see the growth progress. At this point I'm still looking like an ostrich.

Thanks for checking on me,

Beppy

Thanks to my sister, Peg for visiting me last week and bringing me lunch. It was great to see you :)

11/24/13 - Pre Op Appointment


I went for my pre op appointment on Friday the 22nd. I decided against the sentinel node biopsy. I thought the surgeon would give me a hard time regarding my decision, but she was fine with it. Because I've already done chemo, she said she understands why I wouldn't want to have the procedure. I also talked her out of inserting wires into my clips before surgery. When they did the core needle biopsy the radiologist inserted clips into my tumors. Typically right before surgery you have an ultrasound to find the clips and they insert wires through your breast - this helps the surgeon locate the tumors. Because we can still feel the tumors, I convinced the surgeon that we don't need the wires. That's one less procedure I have to go through and one less possible infection.

I also met with the anesthesiologist. Due to my Rheumatoid Arthritis of the neck and the problems they had 10-years ago getting the tube down my throat, they've elected to do fiber optic anesthesia. The only problem with this procedure is I'll have to be awake when they insert the tube down my throat. I'm not too thrilled about this, but I found no way to talk my way out of it. He said he would medicate me so I may not remember.

I had blood work done too. My white blood counts are good but I did have some abnormal results in other areas. My sodium is slightly elevated (146). My AST is high (36) as well as my LDH (182). I haven't received any panicked phone calls, so I'm assuming this stuff is all a result of the chemo. My potassium and magnesium have returned back to normal.


Our Dopey Dog Jax

That was my day of pre op stuff. Everything took about three hours - not too bad. I will report on my first Herceptin only infusion on Monday. Hope you all are having a great weekend.

Cheers,

Begging for Treats
Beppy

11/19/13 - Counts Are Up

Just a quick update to let you all know how I'm doing. My blood counts are up and my digestive system is improving. My ALT level was slightly elevated again but hopefully that will improve now that I'm feeling better. Friday I have my pre-op appointment and Monday I have my first Herceptin only infusion. I have my days and nights mixed up - I seem to be up all night and feel like I could sleep the day away. I hope the fatigue gets better before surgery. When I had surgery ten years ago the anesthesiologist had a difficult time getting the tube down my throat due to my RA. This time they are going to do fiber optic anesthesia. Hopefully I can learn more about that procedure at my pre-op appointment. My lumpectomy is scheduled for December 4th. Once the pathology comes back on the tumors, we will decide on the next course of action.
Baylee - 14-years-old next month

Robyn comes back home on Dec. 3rd and will go back to NorCal on Dec. 14th. Bud and I have really enjoyed spending time with her and we can't wait until she moves back permanently.

That's about all for now. I will update after my pre-op and Herceptin appointments.

Cheers,

Beppy

11/11/13 - ER Visit - Ten Pounds of Poop in a Five Pound Bag



READ AT YOUR OWN RISK - Bowel Discussion

Before starting my chemo I did a lot of research on how it can affect the digestive tract. I discovered that healthy people can really have a difficult time. My biggest fear of chemo was how it would affect many things - my incisional hernia, my reconstruction on the "business end" and my hemorrhoids.  I was also afraid of a new infection of necrotizing fasciitis. It's funny how fears from past events can wreak so much havoc on rational decisions.

I had my last chemo on Monday, November 4th and I was so hopeful that my side effects would be minimal. After all, I did have a whole extra week of recuperation by skipping a chemo. I thought that would give my body the extra boost it needed to combat side effects.  I seem to forget that these side effects are cumulative. I was doing pretty well until Wednesday - that always seems to be the worst day for me. After the Neulasta shot , the come down from the steroid and the start of Cipro, my body rebels. This cycle followed the same pattern but there was one difference. I've always had the severe constipation but with this chemo, nothing was moving. It was like pouring cement into my bowels.

Ready to Bounce Back

Early Thursday morning at around three a.m. I noticed a protrusion from my stomach in the area of my incisional hernia. I was also experiencing pain and cramps. At that point it had been almost four days since I had a bowel movement. Three a.m. is not a good time to discover something like that - all kinds of horrible thoughts go through your head - at least my head. I was convinced that my hernia had strangulated, they were going to rush me into emergency surgery and because my blood counts were down, I would develop necrotizing fasciitis again. Poor Bud. I woke him up and he had to deal with the hysterical nut case he calls his wife. As usual, he was calm and patient. Because we aren't doctors, we really couldn't determine why it was there. He wanted to take me to the emergency room, but my irrational fear took over - so I waited it out. Friday and Saturday rolled around and I was getting progressively more uncomfortable. No bowel movement - not even a hint that I could go. By this time I was exhausted mentally and physically and because I thought my hernia could strangulate, I would only eat very small amounts of food which was contributing to my decline. Robyn was leaving early  Sunday morning and I didn't want her last day in town to be spent in the emergency room (good excuse not to go in, huh?). Sunday came along and I knew it was time to call the doctor. I called the infusion line and explained the problem and got the answer I knew was coming - go to the emergency room. So off Bud and I went for another trip to the puking, germ laden ER. The nurse screened me over the phone so they knew I was coming. The staff got me in right away and even gave me a private room - one of the perks of possible low blood counts. I got a wonderful nurse and they took blood right away - as expected, my counts were way down. First thing the doctor ordered was an x-ray of my abdomen. He said my hernia looked fine with no evidence of strangulation - whew! Now here is the gross part - he said I was filled with poo. Ya think? After a week of not going, that makes perfect sense. It's not that I didn't think that could be a possibility. Bud and I did have a discussion regarding the protrusion being something other than a strangulated hernia. But crazy cancer girl knew otherwise. Now comes the part where I feel like a fool for waiting so long to go in and have it checked. It's amazing what fear can do to a person. They kept me long enough to give me a bag of saline. My magnesium and potassium numbers were down and the nurse gave me an oral dose of magnesium. That was kind of yucky, but she also gave me a juice chaser which was yummy. The doctor prescribed the same meds they use when you have to clear your bowels for a colonoscopy. I knew then it was going to be  fun filled night. Without going in to unneeded details, I spent the whole night palling around with the porcelain god. Needless to say, by the time I woke up this morning, I was exhausted. My intestines
are so sore it feels like I had abdominal surgery. Between that and the cumulative side effects of the chemo, I feel like the walking dead. I guess I shouldn't complain - at least I only had a bowel obstruction and not a perforated bowel or strangulated hernia. The best part is I didn't have to go in for emergency surgery, I didn't have to have a colostomy and I didn't contract NF. I'm such a loon. Although, I am in a lot more pain today than when I was in the ER, which makes me wonder if the colon cleansing did something to my bowels or hernia which in turn would necessitate surgery, risking infection. Welcome to my brain - it's a never ending thought process - wackadoo, wackadoo - a vicious cycle :)

That was my excitement for the week. Thanks for checking on me.

Beppy

11/4/13 - 4th and Final Chemo Day



Finally, my last yucky chemo! I'm convinced the combination of bad traffic and last minute problems makes my infusions go badly. This morning I get a call about 7:00 am from the nurse telling me I didn't do my labs. I explained that I spoke to the Oncologist and he said I wouldn't need labs because I just did them last week when the infusion got called off. She insisted that I get them. My appointment was for 9:30 am and she needed me there an hour ahead of time. There is no way we would make it by then with the morning traffic, so I had the bright idea to get them in Wildomar - by the time we traveled to Irvine they would have the results. Bad idea on my part. We pulled into the parking lot and the place looked dead. We went up to the lab and the line was out the door. Why are so many people getting labs at 7:20 in the morning and where the heck did they park? Needless to say, waiting in that line to get processed would have taken at least 30 minutes. I had stat orders but that doesn't apply until you are processed. So we piled back into the car and off to Irvine we traveled. In the meantime we tried to get the infusion nurse on the phone but they just weren't answering. Finally we got a live person and she said she would send over a message for them to call. Bud spoke to the nurse that would be giving me the infusion and she said they weren't worried about labs? As usual, the left hand doesn't know what the right hand is doing. But she did say we needed to get there in time for me to speak with the Oncologist. I requested a conversation with him to go over my ultrasound results and the lack of tumor shrinkage. I just want to make sure we are on the right chemo course in light of the results. After rushing through horrible traffic, we made it there by 9:15 am. Once in the infusion room, the nurse said the Oncologist was too busy to talk to me. She said he didn't order the ultrasound and I need to talk to the surgeon about the results. Now I'm going to use all the usual clichés I detest- seriously?  really? you're kidding me? My response was, "He is my Oncologist and has decided on a protocol to shrink my tumors, you don't think it deserves a conversation about the ultrasound showing very little shrinkage?  Is the surgeon going to be the one to change my protocol if it's not working?" By this time I was pretty irate as well as emotional. Off she went and three minutes later the Oncologist emerged. He said the only way to know if the tumors have changed would be through the pathology results after the surgery. He said the ultrasound can show that the tumors didn't shrink, but there could be changes the ultrasound can't see. That's really all I needed to hear to continue on with this last infusion. I just needed to know that I didn't do all of this for nothing. Everything I've read has said the goal is a complete pathologic response (your tumors shrink completely, no node involvement). Disease-free survival (DFS) is significantly superior in patients with no invasive and no in situ residuals in breast or nodes after neoadjuvant chemotherapy. So I don't think I was out of line to question a protocol that doesn't seem to be achieving the desired result. All I can do now is pray that by surgery time things change.

Ouch!
I didn't get the nurse I adore today. That never goes well. The nurse I got was really nice but she insisted on putting the IV in my hand - which I hate. It was difficult to get the IV in my vein and it really hurt - upsetting me further. Time for Ativan. I wasn't sure if I was going through with the infusion today, so I didn't take my morning steroid. That meant she had to put it in my IV. She infused the Herceptin first. It took about 30 minutes and I got my usual chills. Taxotere was next which only took 1 hour - no side effects. Last was Carboplatin which only took 30 minutes - also no side effects. Robyn picked up all my medications at the pharmacy once they started the last chemo drug. We were out of there by 12:45 - not too shabby. I'm so excited to be done with the Taxotere and Carboplatin. They want me to have the Herceptin every three weeks for one year. I'm still considering whether the six months my second opinion doc recommended will be better. I don't want heart damage after this last scare, so I will consider that as we go. I can stop it at any time. The good news is when you just have Herceptin you don't need all those medications. No more steroids, no more zofran, no more neulasta (bone crushing shot), no more white blood cell drops, no more pain meds and I can go back on my RA medications. Plus the infusion time is only 30 minutes. So for that reason, and the fact that Bud and Robyn were with me, today was a good day.

So far I've had no side effects from the infusion today. I didn't even get the usual red face. Here's hoping the fourth infusion is the charm! I will keep you all updated as the next few days progress.

Cheers,

Beppy

I decided to be brave and go commando (not where you're thinking)  today. Just call me Dumbo.