Appointment with the Oncologist, Test Results, and Chemo 1 of 6

So, October 15, 2009 was my first date with Chemo. The afternoon of the 14th, the Dr.'s office staff called me and asked me to come in earlier. I failed to ask "why" they wanted this, so I proceeded to freak myself out about the reason they may want to have me come in earlier (this appointment was also where I would hear about my PET/CT/Bone Scan tests.) Yeah, Josh, my Mom and Cheri worked on convincing me that it was just because of cancellations or needing to move around the schedule for something.
I put the Lidocaine Cream on my port area about 1.5 hours prior to my appointment...my mom suggested this based on her experiences with her Dialysis.
Anyway, had my usual bloodwork then my meeting with Dr. Wright, my Medical Oncologist. Cheri and my sister Becky were there with me and they both met him. I asked immediately about my test results, and he said I was "fine." He was surprised I had not been called with the results. I was so relieved to hear that there were no other cancers showing up on my tests...so freakin' relieved!!! There were a couple of anomalies...some nodules on my thyroid, doc said he does not think they are cancer...lots of folks have nodules there, but he wants an ultrasound done "soon." There were some other minor things that I can follow up on later, but my bloodwork was just fine, so there are no real concerns. No other cancer...no metatastes. Thank the universe!!!
So, lots more questions for the doc--mostly about what to expect from the meds, when I should call or be concerned about side effects, etc. He basically said that he did not want me to have side effects or be too affected by them, so he said to let the nurses or him know right away. The nursing staff would be going over all of the potential side effects, when to take the additional medications I had picked up the day before (on what schedule, etc) and other issues.
Went back to the chemo-administration area...nurse put some spray on the site they "jack in" to, and I did not feel a thing when they went in. Hmmm. Not so bad! So treatment started with Aloxi (anti-nausea) then Decadron (steroid to combat any possible reactions to the meds). Then the Chemo: Taxotere...next was the "Loading Dose" of Herceptin (was supposed to get Carboplatin first, but it was not ready yet, and the Herceptin was), then the Carboplatin. About 20 minutes into the Carboplatin, I started having a weird reaction...I felt so freakin' hot from the inside (like a Hot Flash times 10), this weird pain down my left arm...and I started to get tunnel vision. AND, my eyes felt like this strange "wetness" behind them...like cold wetness behind my eyes (weird?) I think I could have passed out, but then again...I may have been able to keep from doing it. My sis went and got the nurse who stopped the meds right away. She gave me some Saline fluids until they could get the doc to check on me. We decided to start again, and I got the same type of response but cut in about half. So, they gave me an IV Push of Decadron. Now...earlier, I had the Decadron over about 20 minutes, this was a push--immediate, and no one told me that there could be some side effects from that!!! Such as: my crotch suddenly felt like I had fire ants biting me all at once!!! Then it spread to a couple of other spots, including the top of my head. That was freaky...I guess if I had known I was going to have "ants" in my crotch and on the top of my head, it would have been easier to handle mentally!
Well, after that wore off a bit, they started me back on Carboplatin again slowly...then they sped it up, no weird response. The Nurse Oncology Trainer sat with me and indicated that she though it might have been the Herceptin that caused me to have the response. Who knows. I suppose I will find out next time.
Anyway, Chemo lasted until 5:45 PM...so I was on the IV from 12PM until then. Wow. Long time. Oh well...one chemo down, just 5 to go of these combo treatments. Still have 16 doses more of Herceptin though.
Ok...so my hair will be gone sometime between 10-18 days after the treatment yesterday...I've decided I am going to be a monk for Halloween. Just need some orange fabric to make a sheath to wear--with my bald head!
After Becky, Cheri and I left, I had Becky go through the drive through at Wendy's...my friend (and fellow Breast Cancer Survivor) Cindy K told me that I might want cold things...she was so correct! I got a Frosty and finished it within about 6 minutes. Damn, that was good. We also went to the CVS on the way home to pick up some Benadryl...to counteract some of the additional side effects I tried to have during treatment.
So, last night was okay really. I just had to take all of my anti-nausea meds and Benadryl...and I slept GREAT. I really did not expect to, and the nurses told me that I may not--but I was fine!
Still felt like I had a furnace burning inside of every single cell of my body...hotter than Hell...oh well. Just keep that fan on me and sweat it out! Drinking lots of fluids to stay hydrated and work everything out.
No real nausea last night...just gassy in my lower intestines and burpy with lots of heartburn. That, I can handle.
Cancer Sucks...at least it appears to have all been cut out so far...now we are covering the "just in case" portion. I really could be quite happy never doing this over again!!!

Shew!

Bone Scan, Monday, 10-12-09

The Bone Scan was scheduled for 9:45 AM on Monday, 10/12/09...my friend Cheri came in to town on the afternoon of the 11th, so she accompanied me for this test. This was again done at St. Joseph's Hospital Medical Arts Building. We went upstairs fairly quickly, I was ushered back to the same place where they did the PET Scan on Friday...they gave me the shot (again, it was encased in a leaded sheath)...then they told me to leave for 3 hours...walk around a mall or something, and drink lots of fluids. I had no idea that we had to come back after the injection! Oh well...Cheri and I went and hit the local JC Penney...heck, they were having one of their killer sales, so we went to town! On the way back to the test...we stopped in for a snack at Sonic.
So, the Bone Scan itself was a bit strange...this large plate comes down toward your face while you are laying down on the table...it takes about 30 minutes or so for all of the pics to be taken. The computer was near me, so after the pics of my head and upper torso were done, I was able to crank my neck around to look at the screen. Odd...I got to see my skeleton. That was cool. I could also see my bladder very clearly...the contrast was really hanging out in there. At first it freaked me out, but I figured...yeah, that would be my bladder.
So, Cheri and I left after this to go by Whole Foods...and then head back to the house. I was extraordinarily tired after this. I just lay down in bed and chatted on the phone until I crashed out. I felt like I had been hit by a truck by about 8PM that night. I slept until about 2AM, woke up and went back to sleep until about 9AM. I felt much better Tuesday morning...did a bit of work from home.
Anyway...still on the waiting game for results...

More tests...or how to make Tory glow?

On Monday, 10-5-09, I got a call from St. Joseph's Hospital to set me up for an Echocardiogram, a full-body PET Scan and a Bone Scan. The PET and Bone scans are both "nuclear" tests that involve injections...so they cannot be done on the same day. Luckily, the folks at St. Jo's were nice enough to lump a couple of them together for me.

I have my Echocardiogram at 10:30 AM on Friday, 10-9-09, and, after a short break, I get injected for the PET Scan that I will have at about 1PM. In preparation for the PET Scan, I have to be super "lazy" all day today (Thursday), the day before the test. I also have to fast for 6 hours prior (except for water), and I am not supposed to "hang out" with small children or pregnant women after the test. The small children/pregnant women thing is a bit disconcerting. I mean...inject ME with the stuff...but then don't get around munchkins after...you might royally screw them up!!! I did ask if I could "plug myself in" to the hospital power grid and run the facility for a while after the test...um, they told me I might just be able to do that! Hell, if I have to have the stuff...at least make it useful...gotta love "nuclear medicine!"

The Echocardiogram is basic stuff...an ultrasound of my heart. Goopy goo--hope they warm it, I have been so cold-sensitive lately. I have had one done once before...I just remember being told my ribs are very close together, so they had trouble getting a good looksie at the ol' ticker...they ended up doing a lot of the looking from the bottom of my ribcage. We shall see how it goes this time.

The PET Scan sounds rather entertaining...laying down for up to 45 minutes with whirring/banging and other fun stuff similar to the MRI. Oh, that is after being injected with the radiotracer glucose stuff. Fun fun! It is interesting to note, that the PET Scan cannot detect cellular-level cancers...it locates masses...they can be small masses, but as I was keenly made aware, much of the cancer in my left breast was so new it was only detectable on the cellular level...the pathology studies were key in seeing all of the processes going on. So, we are looking for masses...breast cancer likes to spread to the liver, bones and brain...no more cancer dammit...mine is not allowed to have spread! If so, the chemo will kill it. I am determined!

Since I feel so great (sarcasm) about tests like these, I asked my friend Lynda R. to accompany me Friday. She will meet me at St. Jo's in the morning...I know it will probably be a bit boring for her (I know, I get to have all the fun!); however, I am truly grateful that she will be there with me. It just helps my nerves to not sit there all quiet...reading some goofy article in "Redbook" and psyching myself out in the worst way. Thank you Lynda! You will help to preserve what little sanity I have managed to maintain this year!!!

Ok...Monday the 12th is when I get the Bone Scan. Same place, at St. Jo's in Tampa...I get more radioactive tracer injected into me (woo hoo!) and they look for both "hot" and "cold" spots on the imaging. Interesting...tumours (benign and malignant) are indicated by hot or cold spots depending on blood supply to the area or the amount of the tracer they absorb. Hmmm...learning more than I ever wanted to know about nuclear medicine...

My friend Cheri F. is coming in to town on Sunday the 11th, so she will have the treat of hanging out with me on Monday for the Bone Scan stuff. Again...I can literally drive myself bonkers during tests like these...I have a tendency to pull inward emotionally and sleep for ridiculous amounts of time after even basic tests. It will be nice to have Cheri there with me!

Well...that's all on the upcoming tests for now...I am off to be super lazy. Hmmm...what to do?

Medical Oncologist Appointment...PET/Bone Scan info...chemo schedule...

This morning, I had my first appointment with Dr. David D. Wright with Gulfcoast Oncology Associates (http://www.gulfcoastoncology.com/) over in Tampa. The office is right next to St. Joseph's Hospital and is not too far from home to make it inconvenient.

I have to say I was horribly anxious last night and before the appointment. I had trouble sleeping...just going over the questions again and again in my head. I had typed them up this time...and added more questions in pen as they came to me.

My friend and fellow Breast Cancer Survivor, Cindy, joined me for the meeting with the doc...she also brought with her a book, Dr. Susan Love's Breast Book, and a gift bag with a Breast Cancer Awareness TY Beanie Baby...a cute keychain and a card. I really appreciated her being there...and I love my little gifts!

Dr. Wright is young...like Dr. Cox, and he is very energetic, smiley and kind. He made me comfortable right away, answered all of my questions, and just generally was pleasant. Since I don't really enjoy meeting new doctors...it was nice to again like someone right away (similar to Dr. Cox). I feel like he took a lot of time with me to go over treatment options and the questions I had or ones that came up. Cindy was beneficial to catch some additional questions that I had missed. Thanks Cindy!

Okay, so next week, I will be having the PET and Bone Scan. Dr. Wright's office will set this up and call me to tell me where and when this will occur. They will attempt to get this scheduled somewhere closer to where I live for my convenience. Dr. Wright will discuss with me the results of the tests when they are available.

The "Standard Protocol" for my type of Breast Cancer is TCH, Toxotere, Carboplatin and Herceptin. I will be receiving the three drugs via my chemo port (on the upper left side of my chest) every 3 weeks for 6 total sessions. After that, the Herceptin will continue to be administered in the same manner, every 3 weeks for an additional 11 doses (17 doses total of Herceptin). Radiation will be with the Radiation Oncologist after the first 6 doses of chemo.

Chemotherapy will begin in 2 weeks, on October 15th. This will give me additional time to recover from the bilateral mastectomy that was just 2 weeks ago...thank goodness! And it will provide some time for the PET/Bone Scan to be completed with results provided to the doc. I will be receiving chemo at the office I was at today, and I toured the area to make sure I would feel comfortable there. It was fine...not dissimilar to the setup my mom has for her dialysis treatments. Luckily, I will only have to be there for 4-4.5 hours every 3 weeks. Heck, mom gets dialysis 3X a week...I think I can handle hanging out there with no problem!

I am having the chemo administered on Thursday afternoons, then I can get a shot on Friday (anti-nausea and other meds if necessary) and recover over the weekend. This way it will not interfere too much with work. The shot may include steroids (although we are going to be very careful with this) Neulasta and/or Procrit. Decadron was also mentioned. I have had interesting responses in the past to some steroid medications, so the doc will be watching this closely. I distinctly remember the last time someone gave me Prednisone...I experienced insomnia for 3 days...AND acute psychosis. Fun stuff! Hell, I managed the psychosis okay...nothing like a break from reality. No one at the UNT Criminal Justice Graduate Studies Department seemed to mind so much...maybe I didn't seem that different than my normal crazy self? Anyway, I told the doc he needed to watch steroid issues with me closely...and he indicated he would be available via phone if needed.

Ok...17 to 18 days after chemo, I will lose my hair. Yes, it will grow back, but ugh. The doc gave me a script for a "hair prosthesis!" That would be insurance jargon for a freakin' wig!!! And that's only the one for my insurance...apparently, "scalp prosthetic" is also used. That one seems wrong to me...my scalp won't fall off...although I didn't ask that question specifically (joking). Well...thank goodness Halloween is coming up...should be no shortage of goofy wigs I can don--for shits and giggles. I will probably get a good one though...we'll see. I have always been so hot natured...lately I have been feeling the effects of cold more...I may just need one. Who knows. I always did like hats...and my sis is a rad knitter. Note to self: find awesome cotton hats...allergic to wool, so wool is out. Maybe Lindsey Lohan (sp?) will date someone (else) who likes good hats this time. Much easier when I can buy hats at Target.

I also have this lidocaine cream that I have to rub on my chemo port prior to my sessions...my mom does this to her wrist before her dialysis...I will get with her for tips on how to best use this stuff. Crazy, the port is just below my skin, and they just go right in with the needle/chemo drugs. EEK. I'll probably need anti-nausea meds just to handle that shit to be honest!

What else? Oh, blood will be checked at each session, prior to starting...and I meet with the doc prior to each session. AND, the doc will be doing the genetic BRCA testing. It is covered by my insurance because I have been diagnosed with Breast Cancer.

OH...and if you are wondering how I will feel after chemo: Doc says I will feel like I have a mild hangover the day after chemo...along with a couple of days after that. He also indicated that nausea is an issue...although I kind of figured this...and when the nurse gave me a script for 3 different prescription medications for nausea, I could tell they were serious!!! Apparently, they will also be giving me anti-nausea meds with the chemo meds as well. I am thinking that someone may have experienced nausea in the past...maybe they were just covering their bases? ;-)

I think that is all for now...although my brain is mush from today. Heck, I had 2 hardcore naps after the appointment. Even with that damn Starbucks fix! Note to self: buy Starbucks store. Give free coffee to everyone on 9/11.

With love,
The boobless one in West Central Florida...the one searching the internet for a hair prosthesis...really? OH shit could I have fun with some wigs...
~Tory :-)

P.S. Doc says I look really strong and vibrant...and that I will be just fine. I know I will. I just like hearing a younger man tell me I look strong and vibrant!