August 3, 2019 - Chemo Talk
Jamie, Mason, and I returned to Atlanta on Thursday, as I had an appointment on Friday with the Infusion Nurse. Honestly, I never knew there was such a thing. As I may have mentioned earlier, our vocabulary is growing through this process. One logistical note, before I continue. Our time at this address in Atlanta ends next Wednesday, August 7th. We will be heading back to Florida Wednesday night. We have Meet the Teacher for Mason on Friday and he starts 4th grade on Monday, August 12th. As you read below, we will be back in Atlanta, but we need to get Mason back home and in a routine.
The visit with the Infusion Nurse was eye-opening. The purpose was to meet before chemo starts, review the chemo drugs, discuss side effects, and prepare for the next phase of this journey. Due to my chemo protocol, I am required to have a PORT inserted to receive the chemo drugs.
A port is a small disc made of plastic about the size of a quarter that sits just under the skin. The placement is typically in the upper chest area. A soft thin tube called a catheter connects the port to a large vein. Chemotherapy medicines are given through a special needle that fits right into the port. You also can have blood drawn through the port.
The nurse gave us a demonstration. I thought Jamie was going to pass out. He is a WONDERFUL care giver to me, but he can't handle needles. Trust me, the PORT didn't look like fun, but I have been assured by friends who have experience that it is not that bad. We also learned how toxic I will be in the immediate 48 hours after each round of chemo. It will be important to wash my clothes separately (two cycles). We will have to be very careful on exchanging bodily fluids, such as saliva. This may not sound like a big deal, but Mason is constantly drinking after me. I will be able to give him hugs, but will need to be mindful of kisses. Suffice it to say, our life will be a little different for 4 months. It is temporary. Now I promised you the chemo talk so here it comes.....
Disclaimer: This post may be tedious, so you may need caffeine to get through it.
My oncologist has prescribed a "Dose Dense" 16 week chemotherapy treatment, that will broken into 2 Parts. Dose Dense means that I will have chemotherapy every two weeks versus every three weeks.
Part 1: "Dose Dense" AC Every 14 Days X 4 Cycles (8 weeks in duration)
AC is made up of 2 chemo drugs: Doxorubicin and Cyclophosphamide. They are more well known by their Trade Names: Adriamycin and Cytoxan, which they are affectionately called AC. The affection is misplaced because Doxorubicin is also known as the "Red Devil". I will speak more about that later.
Dexamethsone (steroid)/Emend (anti-nausea)
Neulasta (white blood cell booster)
**Interim nurse lab visit on Day 10 - Nadir
Part 2: "Dose Dense" TAXOL Every 14 Days X 4 Cycles (8 weeks in duration)
Benadryl (reaction prevention)
Pepcid (reaction prevention)
Now that you know my chemo cocktail, let's talk in real terms. Part 1 will SUCK. Doxorubicin IS known as the Red Devil. It has that moniker for a few reasons. It is one of the most powerful chemo drugs available. It works at destroying ANY cell (good or bad) that is dividing and multiplying. This drug is bright red. I've been told it looks like cherry kool-aid. It is very effective at killing cancer. It also can damage your heart. There is a lifetime dose that is allowed to be administered to a person. I have been told that this round of chemo will not get me close to the lifetime amount, but the fact that there is a lifetime maximum is downright scary. This drug must be administered through a PORT. Doxorubicin is a vesicant (new word for me). A vesicant is a chemical that causes extensive tissue damage and blistering if it escapes from the vein. That is why it needs a central line via a PORT to be administered to your heart.
Unfortunately, the side effects are ugly. They include, but are not limited to, nausea or vomiting, low blood counts, hair loss, fatigue, mouth sores, etc. They are not pretty, but are manageable. I am told to expect to be down and out for 3-4 days after AC is administered. We will see!
When Part 2 arrives, the main chemo drug changes to Taxol. I get to say goodbye to the Red Devil. Taxol is a kinder and gentler chemo drug. There is not a lifetime maximum dose of Taxol. In addition to the the side affects above, we get to add joint and muscle pain. I may also experience Neuropathy (numbness and tingling of the hands and feet).
When do I begin this treatment? We are awaiting release from my surgeon. I have to be healed from surgery before chemo can begin. We anticipate a start date by the end of August. That is my desire, as I would like to have chemo completed before Christmas! That is my goal.
I will have to travel to Atlanta every week for this treatment. The first week is chemo, second week is blood drawn and white cell count measured. Third week is chemo, fourth week is blood drawn and white cell count measured, etc. This will continue for 8 weeks. Doxorubicin lowers your white cell count. It is critical that they they measure the white cell count around Day 10 (Nadir) after you have received Doxorubicin. Nadir is the point in time between chemotherapy cycles in which you experience low blood counts. Low blood counts put you at increased risk for infection, anemia, and/or bleeding. If blood counts dip too low, it could be dangerous and even require hospitalization.
The overall logistics of my upcoming treatment will be a tremendous burden on my family, but we will get through it.
Unfortunately, my incisions are not healing as quickly as we would like. And, I still have ONE pesky abdominal drain left in my body. We are beyond hope that the drain will be removed on Monday. AND, I have a very scary PET scan scheduled for Monday afternoon. I will not lie - I am petrified of the PET scan. I am not worried about the procedure itself, but am anxious about the results. This scan will tell us if cancer has decided to take up residence somewhere other than the breast tissue and lymph nodes. If so, I do know the Red Devil will evict them!
Thank you all who have been lifting my family up in prayer. We feel the love and support. We are praying for clear scans!! We will update soon.
Love to you all!