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.