Another Dose of Cancer Killers on Board!

So far so good today...At least I got a good night's sleep. I finally broke down last night and took something to help me sleep better. You see, they give me steroids before my chemo and I keep taking them for a couple of days after chemo. Those buggers keep me feeling pretty good during the day, but I could stay up all night if I'm not careful.

I'm hoping the unpredictable weather we've had around here (hail and rain yesterday) won't keep my sister from getting here for a quick visit. Poor thing will be out here just when I go off the steroids and the side effects of the $3000 Nuelasta shot really kick in (lots of achiness as my bone marrow is encouraged to make white blood cells).

We have also been treated with a yummy home cooked meal from one of my collegues (thanks Tom!), another box of yummies from Zimmerman's and I got the cutest earrings (just the right accessory for a gal who is slowly but surely losing her hair).

Thanks for all the support we've gotten from everyone (encouraging emails, comments on the blog, facebook notes, hugs, offers of help, and all the things I can't think of!). Knowing we've got so many folks rooting for us helps more than you know!

Good Drip

All done with my second round of chemo. This week I got the whole "cocktail". It went fine, it was a lot quicker than last time (they were less worried about allergic reactions). I was home in less than four hours. I managed to talk them out of the Benedryl this time (I didn't need a crazy nap today!). Some minor side effects from the chemo are creeping in already. My tongue is tingly and things don't taste right. Otherwise I feel fine. I even snuck in a run to Target and Fourth Street! I'm a little less worried this time through because I have a clue about what to expect (yes, it might change, but it isn't a complete unknown).

Warning: I'm going to geek out on the chemicals now. I'm a science teacher (who's not teaching today) so I figure I'm allowed. Stop reading now if you have no interest in how the chemo thing works. Here comes the nerdiness...

I start off my cocktail with premeds of Dexamethasone (steroid) and Emend (miracle anti-nausea stuff). These things are supposed to keep the serious side effects at bay. The next up is an hour long drip of Taxotere. Taxotere was first made from the needles of European Yew trees (now it is synthesized in labs). Taxotere works by binding to microtubules and making it impossible for cells to divide. Taxotere and Taxol are both classified as taxanes (Taxol is the "mother" of all taxanes). Taxol was first discovered back in the 1960's after the National Cancer Institute got together with botanists from the USDA to start screening plants in search of compounds that killed cancer cells. It took about 30 years from its discovery in the 1960's before it was approved in the 1990's (holy cow!). Originally Taxol was derived from the bark of the Pacific Yew. Its use as a chemotherapy drug lead to the harvesting of lots of Pacific Yews (it takes a lot of bark to isolate enough Taxol for a chemo drip!). Not only were Pacific Yews not the most common tree to start with, but they grow in forests where you find spotted owls (a threatened species). This was a problem for the first couple years of use, but by 1995 a method for synthesis of taxol in the lab had been developed and the controversy (helping cancer patients vs. saving the forests and the birds) was over.

The Taxotere is followed by a 1/2 hour drip of Carboplatin (yes, I now have some platinum coursing through my veins). Carboplatin is an alkylating agent. It reacts with my DNA and adds alkyl groups (methyl, ethyl etc). Essentially it causes mutations that will hopefully kill the cell. Like all chemotherapy drugs, neither Taxotere nor Carboplatin can tell the difference between cancerous and non-cancerous cells, so it is killing any cell that is undergoing mitosis. Since cancer cells do this so often, they are killed (hopefully), but there are some civilian casualties as well (hair follicles for one thing- my hair is now starting to come out).

I finish up with Herceptin dripped in over a 1/2 hour or so. I go every week for Herceptin and technically that isn't chemo- it is a targeted therapy that works specifically on the cancerous cells and has very few side effects. My cancer cells have an abundance of HER2 receptors sticking out of their cell membranes. This receptor sends messages to regulate cell division, but in cancer cells like mine the HER2 receptors just keep sending the message to divide the cell. This is no good, it makes tumors! Herceptin binds to the HER2 receptors and stops them from sending out the "divide" message. Once it has bound to the HER2 receptors, my immune system (which according to my blood work is doing fine!) gets rid of the cancer cells. Herceptin (a.k.a. trastuzamab) is a wonder drug for HER2+ folks like me.

Once the Herceptin drips through, they flush my port. The weirdest part of this is that I don't really notice the taste or smell of any of the chemo drugs or the Herceptin, but when they flush my port with saline and Heparin (to keep any clots from forming in it) I can taste both. Saline (which should taste like salt water) tastes very chemically and Heparin tastes like fake citrus flavor, weird. The only explanation I can think of is that they really push that stuff in fast with a syringe (no drip drip here at all!). Anyway, once all that is done, they put a bandage on and I'm outta there.

In related news...there is a "super herceptin" (TDM1) drug that is currently in stage 3 trials that sounds very promising. It combines Herceptin (which binds to the HER2 receptors that my cancer cells have an abundance of) with DM1, a chemotherapy agent. This would get chemotherapy straight to the cancer cells rather than spreading it throughout the body. Who knows when or if I'll ever need this drug, but its existence gives me one more option in the fight!!

Just to give credit where credit is due, the info here came from: my doctors (mostly Dr. Z my breast surgeon), carboplatin.org, taxotere.com, the numerous pamphlets I have been handed by my nurses and The Story of Taxol: Nature and Politics in the Pursuit of an Anti-cancer Drug By Jordan Goodman, Vivien Walsh (the preview on Google).

drip 2 of 6

Off to an on-time start....

Sixteen Days Out and Feeling Perky...

It's been sixteen days since they dripped the toxic cancer killing chemicals into me. I'm feeling almost normal. I think I'm a bit more tired than normal, but not bad. My taste buds returned to normal last weekend, so I've been enjoying eating all sorts of things (so refreshing!).

In other news, I've been totally overwhelmed by the kind words of support from my students. One of them set up a Facebook page called "Mrs Rohmer Get Well" (should be "Ms", really, but whatever...it is totally sweet!!). Reading all of their well wishes and kind words is so touching, and I can't help but tear up. Just one more reason I like my job.

Two more days of work and then I'm off for TWO WEEKS (chemo next week and then spring break is the next week). Yippee!

my sleepy wife.

We had an appointment with the oncologist yesterday, and then Eileen went for her weekly Herceptin drip. As you may already assume, we had to wait a long time for both appointments to commence. (I probably wouldn't be as cranky about it if I could get cell service in the waiting room....I'm a slave to technology. Perhaps I'll bring a paperback next time!)

The onc appointment went well. Her blood and liver numbers are looking very good, so that was a huge relief. We also learned that now she doesn't need to get blood drawn every week as she has been. She only needs to go prior to the chemo mondays. That amounts to 2 less needle sticks- always a good thing!

Once she finally was able to get into the infusion center, the drip went without incident save for one thing; The chemo nurse gave her a small dose of Benedryl. She didn't get that last time (and she mentioned it to him) but it seemed routine. Mind you, I had just gone back to work (after being in the office for more than 1.5hrs at that point...) so I wasn't there to play the heavy. (i.e. "she didn't get that last time, would you please call the doctor to confirm?").

Anyway, not a big deal- we're sure it was fine and all, but holy moly- Eileen was ZONKED last night. I got back home from work around 630, we chatted, ate, and she was out. I took Red for a long walk, she didn't stir. I played music. She only grumbled and rolled over. By 10:30, she finally motored from the couch to the bedroom and slept straight through until 5:30am.

She seemed rather refreshed this morning and in good spirits. Maybe we'll ask about the Benedryl next time- (and by that I mean, "hey man....can you hook us up?")

TGIF

I made it through a full week back at work. I'm tired, but otherwise feeling pretty good.

I went and got my blood drawn today just 'cause. I'm not sure whether I needed to or not, but it seemed easier to go get it done than to call the doctor's office to double check (and I'm kinda curious what my numbers look like). That's pretty stupid, but... I ended up meeting the most fascinating Rainman like character at the lab. He could tell ya all the celebrities born on or near your birthday. It was amazing really. I share a birthday with J-Lo and Barry Bonds. If I was born a day later, I'd share a birthday with Diana Ross. He then went on to people who share the same astrological sign. I don't know how he keeps it all in his head and I really don't know how the receptionist there doesn't go completely berzerk and tell him to shut the hell up!

Knocking on Wood.

I have been knocking on wood all day... I feel back to normal, pre-chemo normal! My stomach has pretty much calmed down and my energy level is great. Being back at work has been really good. It helps me get out of my head. Add to that the fact that the weather here is gorgeous (low 70's and sunny, LOVE IT!). Red (the dog) and I got out for our 2+ miles and could've kept going. I'm doing well (except for the fact that I have FUCKING CANCER, urgh!).

In other news, I have to say I already love my portacath. When they accessed it today it didn't hurt a bit (thanks to a bit of lidocaine). My portacath is this tiny thing about the size of a lifesaver with a tube attached to it. The tube goes straight into my jugular vein. This way I don't have someone poking around trying to get a vein every week! Yippee! Keith and I are both wondering why some IV drug users don't go this route (or maybe they do, who knows right?). It seems way easier than trying to find a vein everytime! (albeit expensive).

I like to bitch.

Sure, I like to bitch on occasion. We all like to get our digs in when we have to wait too long at the post office, or that ass-hat in front of you doesn't signal his turn. Happens every day, and the little frustrations get easily defused with a simple "oh pah-leeeze" or the like. But let me tell you; fuck cancer and its associated ball of potential bitchpoints. I think we hit a new record clusterfuck quotient today. Yes yes, not to worry- it all ended up ok, but FOR PETESAKES!! Argh. I'll spare you some of the details, but the take home points are thus:

-I find it incredibly disrespectful and truly annoying that an oncologist's office consistently runs behind schedule. Take a hint- if your first appointment of the day cannot commence within an acceptable period of time, how about you rethink your scheduling? Today, our 8:45am appointment actually began at 9:12. I know that may not sound like a big deal, but this stuff is cumulative. We've figured out that in 2 visits we have waited to see the oncologist for about 1.5 hours, and we've only seen her for 45 minutes. I'm not a fan of that ratio.

-Sounds like our issue of non-returned calls and calls not getting through to the office has been rectified. I sure hope that is the case, because I can't tell you how frustrating it can be to have an uncomfortable wife asking if it's ok to take this med or that med....and not being able to get that answer in a timely manner....especially after you've been told on numerous occasions to "call anytime, we'll get right back to you". Don't lie.

-And the winner of the clusterfuck of the day: "What do you mean, she's supposed to be getting WEEKLY Herceptin doses??....nobody told us that?!!??" It worked out ok, it being only Tuesday. They were able to get her an infusion appointment right then (well, after waiting another 20minutes or so....remember, it's cumulative!). Turns out the schedule we were given was incorrect. I can accept the screwup, that's fine....those things happen. But, don't you think that SOMEBODY would have caught that a while back and given us a call? Shit like that does not instill confidence.

We see now that we need to be much more proactive with this aspect of the process. We can't be quite as confident that all appointments, prescriptions, and procedures will fall into place when we're told they will be. Followup is my new middle name. "I'm sorry to bother you again, I'm just wanting to confirm this upcoming appointment...is this correct?...oh great, thank you...is the doctor running behind? ok, just checking...."

Ok well thanks for the vent, I feel a little better now.

On the bright side, E feels good to have another dose of cancer killing toxins on board. The chemo nurses are really pretty cool (and were apologetic about the snafu). Our new favorite nurse, "The Animated One", is really really good with needles. E didn't feel the port poke hardly at all this time!

Those tumors don't stand a chance. We may have a scrappy team, but they've got a good set of killing tools.

Fuck you cancer.

Back to school.

Red and I drove Eileen up the hill to school today (and then hiked home). E's feeling pretty good and I know she's excited to be back at work (instead of sitting at home over-analyzing how she feels). Hopefully her ooglyness will remain at bay throughout the day. I've had a full week at work without the hair, but I'm sure she'll now experience the flurry of surprised looks and questions about her new "do". Bound to happen and not much to be done about it.

I'm hoping she continues to feel ok. It'd sure be swell if this is more or less how it'll be (i.e. managable). We're staying positive and taking lots of walks!

Keith

Lazy Days

I've been feeling pretty good the last couple of days. I'm lazy, but have managed to walk between 2 and 3 miles every day this week. Having a dog around helps with motivation!! My stomach is ok once I get going but first thing in the morning I am pretty oogley. After I get some toast things start to settle in.

My mom is on her way back home today. She helped with a bunch of easy grading and recording of grades. I wouldn't have powered through it without her! She was great company during my first round of chemo. All in all, this week wasn't so bad (knock on wood). It'll be nice to go into the next round knowing a little bit about what to expect.

I'm just gonna take it easy, walk the dog, watch some tv and enjoy these sunshiny days before I head back to work on Monday!

Three Days Post Drip

This button came in that crazy amazing gift basket yesterday! It cracks me up.

Feeling tired and achy today. Not so bad that I couldn't get out to do some food shopping and dog walking, but I'm glad I didn't have to go to work.

Hair, Hats and Wigs, Oh My...

There it is; the picture you've been waiting for...Not as bad as I thought it'd be, in fact I could get used to it. Although my head gets pretty cold (actually our heads both get pretty cold).

Today started off with the delivery of the most over the top gift basket you can imagine! Thank you to that entire group!

I'm still feeling pretty good, it was nice to have a day without a visit to a doctor's office! Just puttered around, bought a wig (that I can't really imagine wearing, but what the heck!), enjoyed a calm browse at REI. I never go there on a weekday, it's really quite nice. My mom and I walked the dog and after all that I'm beat. This is the first day where I can really feel the fatigue. It's not terrible, but it's there.

Dinner is being delivered by some of my delightful students and I'm told we'll be enjoying some yummy mac n' cheese and apple cobbler! Can't wait.

So far so good.

I'm feeling pretty good, despite the fact that I've been sitting around analyzing every last thing. I'm happy to report that I'm feeling pretty perky (thank you steroids) and I'm not nauseous (thank you Emend, the very pricey "anti-nausea bomb"). I have spent the day lazying around, getting a shot in the stomach to kick start my bone marrow into making more white blood cells, trying to figure out some insurance snafu, going to Costco to pick up a couple of things before my mom's arrival and chatting on the phone. Not bad for the day after my first session of chemo.

There were quite a few goodies delivered by the UPS fairy today! A gorgeous orchid, a box of yummies from Zingerman's, a new hat and a gorgeous bouquet of flowers.

In other news, Keith buzzed my hair today. I actually like it short (very very short). It's just a little chilly up there. I'll post a photo tomorrow.

I'm off to watch some TV and try to get my mom settled in.

First One Down...

Keith and I are finally back home after my marathon drip, some assing around trying to get scheduled for everything else and getting meds from the in-house pharmacist (way easier than having to go to the drug store!). Keith was great, he came with me this morning and stayed with me for an hour or so, then he went to work for a bit and came back at 2:00. What a guy!

The other guy in my life today was G my infusion nurse. He explained everything, kept me smiling and even let me take a quick picture of my first bag of chemo!!

Everything went fine, but they had us worried at first. My liver enzyme levels were pretty high, so they had to call Dr. Y to check and see if we could go ahead. Thankfully she gave the go ahead and we got started (albeit 45 minutes late, Keith says "that is why you're called a 'patient'").

Before the chemo drugs start they give me a bunch of "pre-meds". This includes several different anti-nausea drugs, benedryl and steroids. The benedryl kicked my ass. As soon as they injected it I felt it. I'm gaining an understanding for intravenous drug use. The benedryl made me sleepy and out of it for a couple hours.

Then the chemo starts (taxotere first, then carboplatin, then herceptin). Everything went in very slowly today just in case I had a bad reaction (my next drip should take less time, thankfully!).

The only thing that hurt was accessing the port. My port is still tender (I've only had it a little over a week) and they have to push pretty hard to find the right spot in there. Once they got in, it was fine, but ooof, I'm going to have to get some numbing cream before my next drip!

Now I'm just sitting around waiting for the side effects to come... Actually, I'm going to force myself to get up and walk the dog in a bit. I should be fine today (with all those pre-meds) and tomorrow I'll go back in for a Neulasta shot (kick start my bone marrow) and I'll start taking some heavy duty anti-nausea pills (the pharmacist called one an anti-nausea bomb). Fingers crossed it all works and I continue feeling pretty good!

Better living through chemistry.

Count Down to Chemo...

Tomorrow at this time I'll be done with my first chemo drip (not done with the side effects, but that's another matter entirely). We've had a lazy weekend getting things pulled together before this next chapter starts. We cleaned the house, made and froze some dinners (and dog treats), put up a new shower curtain (as per the "chemotherapy and you" pamphlet) and Keith dove in to the no hair pond to check the water for me. He says the water is fine and I say he looks great! I'm up next and I'm still debating whether to spend the money on a cute very short hair cut (that will only last a week or so) or to just have Keith buzz it. At the moment I'm leaning towards having Keith buzz it.

I'll post tomorrow after (or maybe during) my drip.

Set for Take Off...

After yesterday's frustrations, today was great!

My CT scan was easy (although I still have that barium gurgle in my gullet, sorry if that's just TMI) and the cardiologist, who stood me up yesterday, fit me in for my heart checkup. I even was told that my kidneys are perfect and my heart looks normal. I'm a sucker for any good news at the moment.

Now I'm all done with testing and I'm even scheduled for chemo! Yes, I will finally start getting rid of this shit!!! My chemo starts on Monday. It'll be a long one because it is my first dose, so I'll need to bring plenty to do so I don't go crazy sitting around for 4.5-5hours!

Not much left to do now but get a blood test (another stick in my battered arms/hands) and wait.

Thanks for all the well wishes!

CT Scan

I had my abdominal CT Scan this morning. There was no waiting, quick service and a really friendly radiologist. I couldn't ask for more. I got there at 8:45 and was home before 9:30. The best part is I have a sub covering my classes until 12:30 so I'm just going to relax and walk the dog now.

84%

In other news, the results of my genetic testing are back. It wasn't a surprise to learn that I have a genetic predisposition for breast cancer. I find all this stuff fascinating (I just wish it didn't apply to me). Here's a blurb from the report:

The results of this analysis are consistent with the germline BRCA2 mutation 2378delG, resulting in premature truncation of the BRCA2 protein at amino acid position 729. Although the exact risk of breast and ovarian cancer conferred by this specific mutation has not been determined, studies of this type of mutation in high-risk families indicate that deleterious mutations in BRCA2 may confer as much as an 84% risk of breast cancer and a 27% risk of ovarian cancer by age 70 in women (Am. J. Hum. Genet. 62:676-689, 1998).

I just can't get over that I had an 84% chance of getting breast cancer. This doesn't really impact the treatment of my breast cancer, although I'll be going in to talk to Dr. Z (the surgeon not the oncologist) about dealing with the risk of ovarian cancer.

Why am I so excited about chemo?

Today I'm cranky, not depressed or down, just cranky. I had an appointment to see a cardiologist to have my heart checked out. The herceptin that I'll be getting in my chemo cocktail damages heart muscle is a small percentage of folks, so they want to have a baseline picture of my heart prior to chemo. The nice part about this appointment is that it fell right at the beginning of my two free periods (I didn't need a sub, yippee! This never happens!). I teach my first class and hustle down the hill to the doctor's office. I get there and wait for a bit before the receptionist opens the little window to say "I'm so sorry, the doctor is home sick today with a fever." WTF! I asked why she didn't call to tell me and get nowhere, urgh. I need this test before I can start chemo. Chemo that I need because this cancer is dividing and dividing inside me (a thought that makes me sick to my stomach). The receptionist can tell I'm mad and freaking out as I tell her I'm waiting on this test before I can start chemo. She starts working on rescheduling me and finds time on Friday when they can fit me in. FRIDAY?!?! I was hoping to start chemo by Friday. I left that office and went right downstairs to the oncologist's office. I'm freaking out and walk in and talk to the receptionist who talks me down a bit. She's surprised they can't fit me in earlier but says even if it is Friday I should be able to start chemo on Monday. I leave feeling better, but still fuming that no one in the cardiologist's office thought to call and tell me not to come!?

Wait, there's more...

I got home and checked the phone; two new messages.

Before I talk about the messages, let me give you the background, I have a CAT scan of my liver tomorrow (another baseline kind of thing). When they scheduled me for this scan (on Friday) they told me I needed to get some blood tests. I dutifully went and got blood drawn (my hands and forarms are now such a mess from all this that a kid asked me if I had gotten my hand slammed in a door, yikes!) on Friday afternoon.

Back to the messages. The first was from someone at the oncologists office who said that they hadn't gotten the results of my blood tests and "I thought I told you how important it was to have these blood tests done." She was scolding me! The second was from someone at the CT scan place who told me at least three times that if they didn't get these blood results my CT scan would be cancelled. So I call back to figure this stuff out and it turns out the lab where I had my blood taken had misspelled my name but they'd finally figured it out and I get to drink my barium tonight!

Yippee!