Round 2

The second and third weeks after chemo are really not all that bad.

One forgets how things go, in other words.

Then infusion day comes around again, the stabbity needle enters the port (EMLA cream does f-ckall for that moment of pain, BTW), and the chemicals begin a-flowing.  Then the next day - the neutrophil boost (pegfilgrastim in this case).

I think I mentioned last time that it's my opinion that chemo wouldn't be so bad if not for the pegfilgrastim shot that's given the day after.  Oh sure, it's meant to boost your immune systems by getting those neutrophils and stuff to come pouring out of the old bone marrow to fight infection, but what isn't fully appreciated is THE PAIN associated with that process.  Deep down bone pain.  It's sort of awful.

'Take a Claritin at night' they say.  I do.

'Then take an Aleve in the morning' they say.  I do.

All is well for a few hours after each administration, but by about 2 p.m. I'm grunting like I'm in labor, hoping it's time to take another nap, just for today, just for an hour, because maybe after that the pain will abate and I can do more than shuffle and moan.

On the plus side, my zombie impersonation is coming along nicely.

On another plus side, there is no ascertainable GI effect this time around, which leads me to believe that I might have picked up a little bug at the infusion center last time I was there that got those gears spinning a little too fast and got me all dehydrated.  So, WIN for that not happening this time.

By tomorrow this groaning pain should be skipping out the door (fingers crossed!), and by Wednesday a return to about 80% power should be in place.

That's about it - I'm still bald, obviously.  My head feels kind of nice when I rub it. 

Tiff out.

Chemo affects it all

It's been a week, folks.

First chemo infusion was on 04 Dec, with a Neulasta shot on 05 Dec.

BTW: chemo for me is docetaxel + cyclphosphamide.  Once every 3 week, plus the pegfilgrastim chaser.

How did it affect me?  Thusly:

-Day of infusion - no biggie

-Day after: no biggie

-Day 3: I believe I blogged it.

-Day 4, a Saturday:  HURT.  Wow, ow.  Pain, ache, ow.  Shiver.  Nap.  No food thanks.

-Day 5, Sunday:  Like Day 4, but WORSE.  Way worse.  No rest to be had, even in sleep.  Can stay awake maybe 30 minutes between naps.  Finding many creative place to rest.

-Day 6, Monday:  Pain is letting up (thanks, Clariitn!)  5 hours of work meetings is about all I can handle.  Napping on a 1-hour nap, 45-minute work schedule, still get stuff done.

-Day 7, Tuesday: Better, somewhat, though still with the loose bowels and really NOT loving the idea of eating at all.  Get work done, only need one nap to make it through the day.  Still shifting sleeping places at night just for novelty and the chance to rest.

-Day 8: Wednesday: A trip in for bloodwork shows that 1) all labs are NORMAL (YAY!) and 2) my BP is super-low and I'm dehydrated.  Jeez, HOW?  (also, I've lost 10 pounds since last week so...)  I'm drinking 2 liters of water a DAY, but a lot of it still still coming out 'the back end' as watery poops, so that's probably no help.  Get hooked up to IV fluids for a couple of hours.  Have no idea idea what I might be missing for work, don't care.  Told to cut out the BP meds until next labs visit.  Drive home, nap.  Try not to expose myself to any food smells, as that will kick off some retching.  Nothing awful.

-Day 9, Thursday: feel pretty good.  Only need one afternoon nap.  Work is productive.  Couch still comfiest place to sleep.  No pain or nausea.  Might be kicking this, hoping the GI stuff goes way soon,

-Day 10, Friday:  Feel almost normal.  Still some chills, but no pain or nausea. 

-Day 11, Saturday:  Feel normal.  No complaints, just need to sit down every once in a while to rest.  On completely voluntary nap taken, because it's SATURDAY.  GI tract appears to be back to normal.  We put lights on the Christmas tree, I bake.  A slice of pizza for dinner. Sleep in bed all night.

-Day 12, Sunday:  Wake up stupid early, and because Biff does too we are at Waffle House by 4 eating delicious breakfast, home by 5 to relax (me) or nap (Biff).  Will decorate some more today, make a tree topper, and throw some more festive bakery in the oven, I'm sure.

So, there it is.  The first few days were OK, but by the third day after after infusion and 2 days after Neulasta, I was completely out of it.  For 2.5 days I was very very uncomfortable, antsy, exhausted, mad, and sick.  Every day after the improvements have been vast and appreciated.

Fingers crossed this is a pattern that repeats and doesn't intensify.  Next infusion is the day after Christmas.

Tiff out.

First infusion thoughts

That's one of 'em.

Wednesday 04 Dec was the first infusion for treatment of whatever residual cancer cells might be bounding around in my bloodstream affixing themselves to far-flung places in by body that only they can find to use to hide from my immune system/natural defenses.

I'm not a fan of lurking cancer, so agreed with the treatment plan to flood my system with poison to eradicate the issues.  Many many poisons.  The treatments are infusions of docetaxel and cyclophosphamide once every 21 days +/- a little Ativan if you're so inclined and a bit of anti-nausea meds to get you over the first few days of what could be very unpleasant indeed.

In prep, I was supposed to have applied some EMLA cream, which is used to numb the skin over the port (it's lidocaine and prilocaine), but I 'did it wrong' and instead of just gobbing on a whole raft of the shit on the site I kind of rubbed it in and then covered with an occlusive dressing.

WRONG, and proved so when it simply didn't do much to ease the sting of the needle going into the port.

No matter - just a little pinch, but not one I was expecting so not the best surprise ever.

Then the blood draw, then the saline, then the pre-meds, then a 50-minute drip of the docetaxel, then a 15-minute flush, then 50 minutes of cyclophosphamide, then a flush and some heparin added, and I was out the door.  About a 4-hour process, all told.  None of which was bad.

I decided to NOT get a filgrastim (Neulasta) 'pod' for home use, because it truly sounds like a pain to manage, so went in the next day for a shot of that to keep the neutrophil counts up, after taking a claritin to ward off the bone pain that can sometimes come as an after-effect of the GCSF being administered (that's granulocyte colony stimulating factor to you).

The shot was yesterday.

I stayed up way too late last night getting work done, then got up too early this morning to start meetings at 6:30 a.m.

Made it to about 2:30 p.m. before the overwhelming urge to take a nap overcame me, and crawled into the recliner, where 2 hours of glorious rest befell me almost immediately.

Pretty sure it was work that did me in, but who knows?  I might be experiencing a little med fatigue, or just flat-out mental fatigue with what this week's been all about.

All in all though, not a terrible experience.  No bad effects, I didn't have to ring the bell, and walked out of the unit feeling pretty good.

I still don't recommend it.

Tiff out.

Dermabond is NOT my friend

It really sorta does have something to do with this post.

A couple of weeks ago I had a chemo port placed.  Pretty standard-issue stuff, but the process was still weird.  It's never a good thing to be completely aware that your flesh is being rent asunder and objects placed within your body.  The tugging and pulling - ugh.

As often happens with surgery nowadays, the sutures place under the skin are supposed to 'dissolve' in 7-10 days, to which my body says 'HAHAHAHAHAHA!!!  SO FUNNY!'  Nope - not gonna happen.  My system will chew on those suckers for several weeks before deciding it doesn't like the taste of them atall and does NOT want that ish dissolving anywhere near it, so it spits them out.

That's right.  Stitch spitting is a thing, and not just at county fairs.  It's actually not all that uncommon, so I'm not a total and complete weirdo, but yeah, the process can take MONTHS before the last remnant is evicted.  Do NOT GIS that if you know what's good for you and whatever you last ate.

AND NOT ONLY THAT, but nowadays the surgeons like to close the superficial wound with skin glue, or 'Dermabond.'  Approximate the edges, slather some of that stuff on, and et voila - in a few seconds you have nice tight junctions that should remain stuck in place for at least a week before sloughing off. Just don't get it wet, by God, or  the dermabond might dislodge prematurely and who knows what evil will find its way into your body and render all reasonable medical aid pointless?  It's your funeral, bub, at least you'll be clean for it, you water wastrel.

Word to the wise: if you've ever experienced some sensitivity to medical tape like is used on wound dressings, beware the Dermabond.  BEWARE, I say.  Because if you've had a reaction to other  adhesives, you have a very high likelihood of reacting badly to Dermabond.  Oh, the old-school medical journals thought atopic reactions were rare, but do a touch more digging and examples GALORE begin to surface, must like the horrible itchy blistery rash will if you are exposed to the Dermabond.

I could not figure out why the incision sites were so damned itchy, and painful, and annoying.  Just to accidentally touch them, even under the occlusive dressing, was horrible.  I wanted to SCRATCH them, but even a light finger-press on the sites made me want to punch a Viking.  Relentless itching, and flashing pain.  I was loath to remove the dressing because 1) do NOT get the sites wet, do you want to kill yourself? and 2) I was afraid the skin might come along with the surgical tape, much like what happened after getting my c-section dressing removed. 

As luck would have it, jut about a week after the placement I had another doc appointment, and the head nurse wanted to take a look at the site, so removed the dressing.  She SAID it looked like it was healing well, so of course I took her word for it.

Until I got home.

Y'all.

It looked like I had a second-degree burn in the shape of what I can only imagine was the brush that applied the glue.  The skin was discolored a deep brown and was DRY, wrinkled, and very not-right-looking.  And was still itchy.  Like a medically-induced poison ivy rash, really.  Very sexy.

(Also do not GIS 'dermabond reaction.')

Remember that thing I was told about the Dermabond coming off on its own in a week or so?  LIES.  It was 13 days before that shit started to roll off my chest, and as my older son pointed it, 'that was probably also the top layer of your skin Mom.'  There's a very good chance he's right about that. 

But what (generally) sweet relief.  I've been able to sleep in a bed for a few nights now (previously it felt like the site was going to open up if I laid down, such was the tugging and pulling on the wound site), and I can turn my head enough to see traffic without having to swivel my whole torso.  Glorious.

Bottom line is this: If anyone ever comes at me, scalpel in hand, in the future and swears that they're closing with Dermabond and it doesn't cause skin reactions, I'm going to pretend they're a Viking.  And punch them good and hard.

Tiff out.

Ranking the surgeries

If you're wondering, the answer for me is 'YES.'

I promised a takedown of my recent surgeries, and will now rank them in order of which one I'd be 'OK doing again' to 'please never again.'

#1) Biopsy of a mass in the boob: The anesthetic was a little squinchy, but the nice nurse held my hand so I wouldn't try to 'help' the surgeon sterilize the punch zone.  A few pokes and tiny cores samples later, and I was out the door in next to no time.  Steri-strips held me together A-OK and the bruising was minimal.  10 days to no visible after-effects.

#2) Extraction of a broken tooth: the lead-up is always super-owie when you're walking around with a fractured infected molar - who would have guessed?  This is one surgery (I count it as such bcs of the stitches placed to hold the gum together once the offending member is removed) that has real and immediate benefits, friends.   Yank that tooth out, stick some dead guy's bone powder in the deficit, squash some surgical membrane on top of that, and stitch 'er up.  Yeah, sure, the 'soft foods' dies must be obeyed, but I LIKE mashed potatoes and refried beans so no huge sacrifice.  Not like I want to go around chewing on hard things and risking further fractures!  Also about 10 days to heal and for the stitches to fall out (I do NOT 'absorb' stitches like doctors keep telling me I will).

#3) Breast lumpectomy:  I wasn't aware it happened, and that's for the best, I'm sure.  Apparently I am 'difficult to intubate,' and wound up coughing up a few clots for a couple of days and had a very sore throat for a week.  The two surgical sites healed up pretty well over a couple of weeks, though the site where they took a few lymph nodes for testing was SORE for at least 3 weeks.  The actual lump extraction site stopped hurting after about 5 days, but node site didn't want to give up that easily.  I think there are stitches wanting to rise up and escape through the skin, is what I think.

#4) Chemo port placement: I WISH I wasn't aware of what was happening, but was not given the choice (not that I'd have wanted more general anesthetic, given the whole intubation issue).   Awake and aware the whole time, for the lidocaine to the IV placement to the cutting and pulling and tugging and stitching, I knew about it all.  Certainly unpleasant, and a week later the port site STILL hurts but is, according to the oncology nurse I saw yesterday, healing well.  I suppose when a fair-sized lump of plastic is shoved under your skin and then said skin is stitched up (AGAIN WITH THE STITCHES!), there's bound to be some long-term sensitivity.  But still.  It's freaking pain, and I haven't been able to shower for a week now, what with water being the Enemy and such.  I did take a bath two days ago, which was great, but there's something about being older and chubby that makes getting OUT of a tub way way harder than getting INTO a tub. 

So yeah - 4 surgeries in the last month or so, if you can believe it.  I've done my time in the operating theaters of Wake County, is what I'm saying, and don't want to have to read another after-care pamphlet anytime in the near future.

Oh wait.  I start chemotherapy in 10 days.  There's a whole BINDER full of stuff I need to read up on.

Maybe I'll go shop for head scarves first.  Folks tell me it sucks being bald in the winter.

Tiff out.

Headed into port

Sure wish this was the 'port' in question.

Woo, y'all.  I had me a day yesterday, I'll tell you that much.

It's not every day you get scrubbed up and have a piece of medical machinery stuffed under your skin and into a vein, I suppose, but that's what happened to me yesterday.

I am now the proud symbiont of a 'power port,' which sounds cool, like I can now charge my cell phone on my collarbone or something, but the reality is a little more harsh.

This port is there for chemotherapy.

Yup.

Ya' gal got diagnosed with breast cancer a little while ago,.  Had a lumpectomy about a month ago, then once healed from healed from THAT got the news that not ONLY was radiation part of the plan for a potential cure, but chemotherapy was considered a wise add-on (something about 'fast growing lesion') prior to the radiation in order to ensure the best possible chance for said cure.

The chemo is a HUGE surprise.  I should be researching 'short hairstyles' right quick, because I've been told its all a-gonna fall out in a few weeks.

But, no.  I kind of don't care what the hair looks like, and I digress from the point of this post, which is the port.

The POWER PORT.  Different from a regular port, because with a POWER PORT I will be able to withstand pushes of CT contrast much more easily than trying to deliver it through my tiny weak arm veins, because there will be more CT scans with contrast in the next few months.  Guess that doesn't happen for everyone.  It's difficult to find the silver lining...

And THIS is for a person who got an 'all clear margins' on the lumpetomy!!

Nothing's ever easy.

Tiff out.

All clear!

Nothing atall to do with the lead story here.  Read on for the tie-in.

I mentioned a CT scan in the most recent post.  Because I had one.  Because there was some concern that what currently ails me had escaped the fence and might have gone a-wandering.

Nope.

No evidence thereof.  All clear.

Praise be!

---

Also, I am the kind of Mom who gives her grown son magazines like 'Eating Well' and 'Real Simple' to maybe help him get ideas about cooking and life and stuff.

I KNOW those mags have turned toward the women's market, but they're chock full of good stuff and I don't think that just because a magazine has ads for tampons in it they should be shunned by the male population who might get some good out of an article on getting your financial house in order or how to cook a roast or set a table or talk about difficult issues or make a pie crust.  These are not only women's issues, for Pete's sake!

Even that feminine hygiene thing.  Because apparently 60% of women are wearing the wrong size sanitary pad.  I mean, that's not something a guy can mansplain to a bunched-up gal, but at least he can be aware of the issue, right?

---

Speaking of children - our boys came over for dinner tonight and it was fabulous.  Chili, cornbread, dominoes, and conversation.  It was great.

Except that last hand of dominoes.  All tiles drawn on the first round, and only two people could play.  The winner got by with only about 230 points in the last hand.  Cut-THROAT.

Tiff out.

Ranking the Scans

Your medical professional will let you know if you must buy tickets to this ride.

In order of my preference of bodily scans, on a scale of 1-10:

1) Ultrasound: fun, slippery, motion pictures, 3-D live action, just a lil' chilly.  Ease level = 1.

2) X-rays: no pain, no chill, just 2D obscurity. Possible visual payoff at the end now that we are in this age of digital X-ray, which is very cool. Ease level = 1.

3) Mammogram: necessary:  Just do it, just don't wiggle around too much or the squishing will re-commence.  Play 'statues' with yourself and see if you win.  If the operator is nice they'll let you look at the insides of your own boobs at the end. Ease level = 2.

4) CT scan (with contrast): tolerable.  GI oral contrast kind of yummy (lemonade flavor).  Bed comfy enough.  Would be better without the IV contrast, to be honest, that stuff had my heart doing a jig for the first couple of minutes.  Breath holding a challenge.  Fast.  Nothing to see when they're done.  Ease level = 2.5.

5) MRI (with contrast): Somewhat tolerable.  Probably better if not done face-down.  Staying still is a challenge, many noises are a distraction, the light rock coming through the headphones barely cut through.  Contrast feels weird.  Like experiencing a light skirmish where your body is the actual field of warfare.  Also nothing to see when they're done.  Ease level = 4.

So, what on earth might be a harder level than laying on your stomach with an IV needling your arm while a whirring, clanking robot scans your body for deficits and you can do nothing but lie there quite still and allow things to happen?  I'll tell you: doing ANY of these things while in pain, or fear.  That's what the dentist is for - X-rays of broken teeth = a 7 on the 'ease' scale, at least.

In the last few weeks all of these things have happened to my body, and I was in no pain at any time (well, except for the dentist).  Not even for the IV installs.  Phlebotomists are getting good, my friends.

Next up: I'll rate my three, no FOUR, recent surgeries.  Newest one is in 2 days, so stay tuned!

Tiff out.

PS - the last couple of months have been interesting.