Friday, October 16, 2009

Better Lucky Than Good

Or maybe I should title this post "Waiting for the Other Shoe to Drop"...

Since I last wrote, I've had chemo treatment #1 and #2. And I have to say, I feel okay. Shockingly so, all things considered. Now, I by no means feel normal but it certainly could be much worse.

As I sat through my first treatment, my fabulous sister Betsy at my side, every horror story I'd ever heard or read about the side effects of chemotherapy played through my head. I wondered when It would kick in- would I feel bad right away? That night? The next day? How sick would I be? And the honest answer is not yet and not very.

Please note, I just knocked on every wood item in my sewing room.

So far I have been very, very lucky. I'm tired. My appetite is about 2/3 what it normally is (not necessarily a bad thing) and I feel nauseous from time to time but by resting, napping and using the anti-nausea medications my oncologist prescribed I have been able to get through it in an almost normal fashion.

And I am so very grateful. I know the effects of chemotherapy are cumulative, getting worse as treatment progresses so to be able to start in a place that is not-so-bad is definitely something to be thankful for, even if it does, in some monstrously perverse way, make me feel like a bit of a chemo-fraud: "Hey look at her, thinks she's a chemo a patient! Why, she hasn't thrown up once."

I'm weird, I know. But this whole cancer episode has such a feeling of unreality for me I think maybe I am looking for some physical touchstone to say, yes, this is really happening. I don't know... Or maybe I am just weird, worried I don't have the right cancer street cred.

If I do lack cancer cred, I have my wonderful oncologist to thank. He's put me on treatment protocol where I have treatments every week for twelve weeks. Most breast cancer patients have treatments every 2-3 weeks. The thinking is that with more frequent but smaller doses of the drugs, the side effects can be somewhat minimized. So on Fridays I go in and get an infusion of Adriamycin and then I take Cytoxan daily orally (pill form). When I am done with this twelve week treatment I'll do 4-6 treatments of another drug- the name escapes me right now.

You'd think that I could simply be grateful the plan seems to be working and that I feel pretty good so far. But no. I worry. I admit, I'm a worrier. I wonder if I'll wake up tomorrow and just feel horrible. I mean, I have Cancer for goodness sakes!!!!! Shouldn't I feel wretched by now? If you read more than two or three posts on almost any breast cancer forum you'd think so... and so, as I mentioned at the beginning, I am sorta-kinda waiting for the proverbial other shoe to put in an appearance.

Yes, yes, I know. I should avoid the crazy forums. But honestly, even the forums you think are going to be normal and un-alarmist and possibly even educational dissolve before your very eyes into a puddle of crazy. I've lurked on a few breast cancer boards (yes, I know! I shouldn't Google... but really, it's Todd's fault- he Googles and sends me links) and frankly, I can't hang out there much. The Drama! Seriously. I cannot take it. I think this might be my own personal oddity again.

I know many (most?) people see cancer treatment as a battle, a fight for their life and I understand the reasoning behind that- you are after all, trying to save your life. Makes perfect sense. And I think that is where the drama stems from. After all, saving your life might be thought of as a Big Deal.


I just cannot get that worked up. Treating and beating my cancer has just become another task on my To Do list. A serious task, no doubt. Clearly a bit more pressing than say, taking out the recycling, but not as urgent as feeding my rapidly-descending-into-hunger-induced-crankiness kidlets dinner (and for the record, the last 5-10 minutes before dinner when you are fervently willing the food to Just. Cook. Faster! before your children really do turn into blood sugar deprived demons is clearly the Tenth Circle of Hell that even Dante was to afraid to explore).

Some days I think, What is wrong with me? Shouldn't I be more upset? Impassioned? Pissed? (Insert appropriate entry from the thesaurus here)? But then Matt grabs a toy away from Gwen or someone spills something or Gwen yells from the bathroom that she needs to be wiped for the 400th time that day and I have to get over it and move on with my life.

So yes, this Friday is treatment #3 and I'll probably feel a little (or maybe a lot) worse next week just as I felt not quite as good this weekend after #2 as I did after #1. But that's okay because I'll be able to check off another box on the To Do List. One step closer to checking off the really big box.

Thursday, October 08, 2009

Better Living Through Chemistry

Throughout our marriage, when one or the other of us has been sick and needed to take some medication, Todd and I have always made some joke or statement about "better living through chemistry". I'm not sure where the phrase originated... I have a very vague notion that is was a tagline in a commercial for some chemical conglomerate at some point... you know, one of those ads where they show you all these things you use daily and then at the end there's a tagline and the name of some company you've never heard of that, I guess, makes some component of all those products. I've never really understood the point of that type of ad but whatever- it's their advertising budget.

But reminiscing about commercials of yore is not where I was going with this post.

Sound the trumpets, I finally have a treatment plan! I've actually had it for a couple days but I've been busy trying to get my ducks in a row and so the poor blog has been neglected.

As I believe I mentioned in a previous post, I am going to be bucking the usual breast cancer treatment trend (surgery then chemo or radiation or a combination of the two) and will be having chemotherapy first followed by surgery. For those of you who like to be able to throw around fancy medical terms, this pre-operative chemo is more properly called neoadjuvent chemotherapy.

And I start on Friday. Two days from now.

Cue small freak out.

Do you want all the nitty-gritty details? Hmmmm. I wonder if I can explain all this without heading into novella territory?

I'll try- bear with me.

So, if you were paying attention (see, I told you there would be a pop quiz!) you might have noticed that I called my cancer "triple negative" in an earlier post, but I did not explain what that meant. Let me do that now because it figures prominently in my treatment.

Triple negative means that my cancer is ER, PR, and HER2 negative.

Um, yeah. That makes it clear, thanks Katie...

Here's the translation:
ER - Estrogen receptor
PR - Progesterone receptor
HER2 - Human epidural growth factor receptor

Breast cancer can be positive or negative for each of these receptors. If you have ER+ cancer, for example, estrogen will fuel the growth of the cancer. On the other hand, if you are negative for a certain hormone sensitivity your cancer is unaffected by the presence of that hormone. In recent years, great strides have been made in developing new drugs that target cancers that are positive for these hormones. Drugs exist now which essentially block the cancer cells from getting access to these hormones which encourage them to grow and reproduce. These drugs are far more targeted than older drug therapies which go after any fast growing cells (your hair, the lining of your stomach). As a result, the newer targeted therapies have improved the chemotherapy experience for patients with hormone sensitive cancer (don't get me wrong, it's still unpleasant, it's just not horribly unpleasant).

Following so far? If you are, you might realize that I am negative for all three of these little receptor types. This is fairly uncommon, in fact, only 15% of all breast cancers are triple negative.

So what does that mean? It means, that instead of a "nice" targeted drug therapy I get to have what I like to call Bazooka Chemo. Take out everything in it's path, say buh-bye to your hair, hope you like feeling nauseous chemo.

Wheeeee! Fun!

Can you tell I'm looking forward to this?

Now admittedly, I am being a bit harsh. Even though I will be having some serious toxins pumped through my body these are not the bad ol' days of chemo. There are much better coping mechanisms available to chemo patients: anti-nausea medications for example, and white blood cell boosters to help prevent or lessen fatigue.

In fact, I thought the white blood cell booster sounded pretty fabulous until the nurse explained to me that it is a DAILY INJECTION!!!! Have I mentioned my fear of needles? Yup. Daily. So I can either go to the clinic every day or I can learn to give myself the shots.

Yes. This was the part of the appointment where I wanted to run screaming from the room, bury my head under the nearest pillow, put my fingers in my ears and sing "La la lalalalalalalalalala".

I shocked myself (and, no doubt my poor mother who held my hand through many a teary near fainting experience with needles in my childhood) and learned to do it myself. It took me three or four preps to do it but I did.

Admittedly, there was a third option: have Todd give me the shots but let's be serious, love him though I do, he is a bit of a bull in a china shop. No way in Hell is he getting in the same zip code as me with a needle.

But even armed with all of these helpful things to lessen the side effects, it isn't going to be a picnic. And while I am excited to be making progress toward ridding myself of all the nasty buggers I would lying if I said I wasn't apprehensive about the chemo.

Tomorrow afternoon I go in to have my Port-o-Cath placed. I'll be under conscious sedation for the procedure so I'll be pretty loopy the rest of the day. Hopefully I'll be too fuzzy to dwell on the fact that I'll be pumped full of some nasty chemicals the next day.

So, yeah. Treatment starts in less than 48 hours... kinda' freaky. And this time I'll really pushing the boundaries of better living through chemistry because, let's be brutally honest, for me, it's living through chemistry.