Sunday, March 22, 2020

My chemo regimen

Almost done with the last one.  

To wrap up my chemotherapy journey, here's a bit of background -

I was diagnosed with estrogen- and progesterone-positive, HER-2-negative breast cancer in September of 2019.

I had a lumpectomy and sentinel lymph node dissection in October 2019, and a power port placement in November 2019. 

Chemo started 04 December 2019. 

This is my treatment regimen, once every 3 weeks:

  • Day before and after infusion - 4 mg dexamethasone BID

  • Day of infusion - by mouth - Pepcid 20 mg (antacid), Decadron 12 mg (antiinflammatory),  Ativan 0.5 mg (sedative)

  • Day of infusion - by port and in order saline 500 ml bolus, Aloxi 250 mg (nausea med), Cinvanti 130 mg (nausea med), Taxotere 133.2 mg over an hour (anti-cancer chemotherapy), Cytoxan 1065.6 mg over 45 minutes (anti-cancer chemotherapy), then a heparin flush.

  • Day after infusion - Neulasta 6 mg subcutaneous (stimulate white blood cell production).


Translation of brand names to generic:

Pepcid: famotidine.

Decadron: dexamethasone

Ativan: lorazepam

Aloxi: palonosetron

Cinvanti: aprepitant

Taxotere: docetaxel

Cytoxan: cyclophosphamide

Neulasta: pegfilgrastim


Common effects of this treatment regimen for me have been:

  • Irregular/rapid heartbeat for a couple of days after infusion - a known side effect. Can be ameliorated somewhat by heavy hydration to flush out the meds.
  • Bone pain starting 3 or so days after infusion, 2 days after Neulasta.  This is a known side effect.
  • Fatigue.  Obviously a known side effect.
  • Nausea about a week after infusion.  Also a known side effect for which medications were prescribed.

Oh, and my fingernails are in the process of falling off.  This is common and is the same as hair loss, which is an expected effect of both Taxotere and Cytoxan.  I expected the hair loss, but  was hoping to keep the fingernails.  No luck.  Oh well.

All in all, while chemotherapy isn't something I'd wish on anyone, it wasn't so bad and certainly a better experience than I would have had a few years ago.  Treatment options and medications have improved since then.

That's it.  One for the memory books, that I probably won't whip out for the grandkids.

Tiff out.

Thursday, March 19, 2020

Chemo's over. Done with. I hope I never have to go back.

The magical unicorn stage has been reached!  Pretty soon that ol' port can come out!

Dose #6 happened today.

The. Last. One.

The last PLANNED one,  I should say, because never say never when it comes to that rat bastard cancer.  That's a bet you shouldn't hedge.

So yup - last one.  The process went well, as usual, with supportive nurses and The Comfy Chair (I never did use the massage function), and Biff the Bagel-Getter.  We were lucky, today is the last day they're allowing visitors in the ward.  Tomorrow I would have been without a delicious breakfast bagel unless I went before the appointment!

After I was unhooked from the machine and was getting ready to go, all the nurses came over with noisemakers and harmonicas and shout-sang 'For She's a Jolly Good Fellow!' with gusto, right at me, then gave ma graduation certificate and a bag full of what I think is Aveda body lotions and stuff that volunteers make to hand out to us graduates.  Pretty neat, and I apologize to anyone on the ward who was trying to catch a few winks as I was leaving.  I hope it's your turn to be feted really soon.

So, yeah.  Done.

Pretty happy about that.

Now comes radiation, so we're only done with stage 1 of treatment.  But still, chemo's done.  That's huge.

Tiff out.

Tuesday, March 17, 2020

The one with all the nausea

It's caught up with me, the chemo has.  Four rounds of it and I didn't really experience many issues, but that fourth round, the one that saw my neutrophils plummet and got me on an antibiotic and made my fingernails hurt?  THAT one set me up for some later-stage nausea that just Would. Not. Go. Away.

I did not take medication for it, being the fool I am, even though I've had the medication at the ready since chemo started in December.  Didn't really 'feel bad' enough' for me to put yet another chemical in my body.  Powered through, like we're all supposed to do.

Idiotic?  Oh my yes.

Then came round 5, which started out fine but then my fingernails started to delaminate (at least I THINK that's what's going on, as the nail bed is turning white from the tip toward the base and it feels like they are separating from the finger itself but I'm not testing that theory too much because it's gross and I'm not about the life right now), and I have had some muscle aches (likely from sitting around all day), and then, a few days ago, the nausea struck again.

Oh the nausea.  I'm OK-ish in the morning, but by mid-afternoon I'm praying that my stomach would just go ahead and heave already to satisfy whatever demon has poking my vagus nerve and playing the world's WORST game of 'tickle fight' that invariably ends up with my face in a trash can, coughing and heaving and crying and blowing snot.  It's not a great look, and it feels even worse.

What prompts me to write this is that I just had an attack a few minutes ago.  I'm sure it was great fun for Biff to listen to, what with all the choking and gasping and shit.  Thankfully, nothing generally comes UP, so it's just a lot of terrible noises and some sweating going on, but still, there's no good way to puke, is there?  Heaving brings momentary relief, but only momentary.  It may come back, certainly by tomorrow.  At this point I have to admit defeat - chemo has gotten the best of me, and I'm quickly giving up even some 'not-great' parts.  

Time to go bust open that bottle of pills.  Idiot no more.  I'm going to chase that fricking demon out and grab back some goodness in my current living situation (such as it is with all the coronavirus sequestering going on.  I don't leave the house much/at all right now, being as how I don't really relish the notion of heaping a potentially deadly respiratory infection onto my current list of issues).

Silver Lining: Final infusion is in 2 days.  Praise be!

Tiff out.

Saturday, February 29, 2020

Rounds 4 and 5

Me and this guy don't get along all that well.

One thing I can say about the memories of round 4 of chemotherapy is this:


Or at least it sucked for ME.  I was put on a 7-day course of it to guard against potential infection, because as of a week after infusion 4 the ol' neutrophils hadn't come up to speed and it would have been very easy for me to get buggy and sick.  So, Levaquin.  Which sucked.  Muscle aches, rapid heartbeat, constant nausea, you name it.  I made it 5 days until the next scheduled lab work, and was relieved beyond measure when the tests came back in the normal range and I was given permission to go off the antibiotic.

This is only my experience.  Not everyone reacts like this to it, I'm sure.  I appear to have a very low tolerance to this particular drug.  It happens.

Just don't want to have it happen again.


Round 5 happened a couple of days ago.  Other than the nurse basically attacking the port site with the alcohol swab to clean it before access (weird, the ouchy accidental bashing sort of helped take down the pinch of the needle access!), everything was fine.  No reactions, chair was as comfy as ever, no complaints.

Sent Biff out for Bruegger's bagels (right around the corner from the treatment center!) and asked him to get a dozen + schmear for the staff, which he did and they appreciated.  I opted for the smoked salmon on an everything bagel, because I can taste it and I'm worth it.  Biff gets the Western bagel with a tomato schmear.  Breakfast almost in bed!

The day after infusion I go in for a shot to pump up my immune system.  Normally it makes my bones start to hurt a couple of days later.  That'll be tomorrow, if I'm lucky, though the twinges are starting up now.  I'll take a Claritin before bed to get a jump on it and then a couple of ibuprofen in the morning to manage the discomfort, but that's about it.  Other than drinking a ton of water and taking my regular meds, that's about the extent of my after-care.

My nurse-oncologist is really happy with how I'm doing, which makes me feel great.


Next one's the last one.  Then we start radiation.


In a bizarre occurrence, during this most recent infusion I had a great need to find out what time it was at one point.  When I checked, it was around 10:30.  No real reason to need to know the time, because where was I going anyhow?

Turns out it was around that time that my former sister-in-law was passing away after a long road with her own (rare) cancer.  She would have been 55 next week.  She will be missed by family and friends for a long long time.

Tiff out.

(image by By MarinaVladivostok)

Tuesday, January 28, 2020

Round 3

That's pretty much it.
Chemo #3 is over which means I'm halfway done!!  Yay!!

And because chemo was 10 days ago, that means I'm halfway through the 3-week infusion cycle.  Each cycle, it's taken about a solid week to start to feel decent, and even then 'feeling decent' only means that I MUST nap once a day. 

Today is the third day in a row that I haven't napped, but I might just sneak in a quick one while the sun shines brightly through the kitchen window.  Can't work in the kitchen right now what with that sun, so why not practice some self-care?

Seems like every round of infusion I get a little GI bug, or the chemo just lingers a bit longer than a week and the stomach/gut upset is a manifestation of its perseverance.  A week +  day after infusion I usually wander around trying to get warm and feeling like there's a little fever milling around my person.  I know what to plan for, so it's not bad, but I do feel under the weather for a bit over a week.

Ain't nothing like days 3-5 though, so I count my blessings.

And while this whole cancer thing isn't everything that's gong on in my world, it sure does color it a different shade of reality. 

This too shall pass.