Week 16 = LAST INFUSION!

The day arrived = my last chemo infusion! Woo hoo!

I had an early appointment yesterday, all the easier to ensure that there were fewer delays and I could get done with a minimal delay. It turned out to be a fantastically good move, since the infusion room got mobbed around 12:30, when I had about an hour left with the needle in my arm. They'll be closed on Thursday for Thanksgiving, so maybe that has something to do with it.

I was so early on the schedule that I was actually a little worried the doctor would come in before I had a chance to put on my little surprise:

I was debating what I would say (i.e. "you didn't warn me about this side effect!"), but words weren't necessary. She lost it as soon as she saw me. And told me I had to wear it into the infusion room. Which I did. The nurses loved it. Hey, if I gave them all something fun to talk about, all the better.

Oh, and the doc also mentioned that one of her other patients actually started growing a little bit of a mustache after the chemo shut down her ovaries. The poor woman: lost the hair she WANTED to have, got the hair no woman wants!

Anyway, the medical news: the doctor was pretty happy with my numbers. She told me that it looked as if I could skip the Neulasta she was recommending during my last checkup. We'll see what next week brings in terms of white cell counts, but so far, so good. Apparently I'm still exceeding expectations in terms of side effects and the fact that none of my treatments has had to be delayed.

I'm confident that some of my preemptive moves -- heavy water consumption and 3x daily saltwater mouth rinses, for example -- played a role in how I've been faring. And I guess that being relatively young (for breast cancer, at least) and reasonably healthy hasn't hurt either. I do wonder if I've been washing the chemo out of my system too quickly for it to have an effect, but as the doc has told me before, my numbers have proven that the meds are having an effect on my system.

All that said, I have to get through the fatigue and ickiness of the next couple of days, the low immunity next week and then the full recovery. I'm starting to ask about the longer-term recovery stuff -- like when my hormones will get back into gear and I go through puberty again (oh, joy). Not to get all technical and stuff, but right now my body is acting as if I'm nine years old. Not sure if the Neulasta had anything to do with this, but I noticed that I was getting PMS zits last week, so maybe things are waking up again. The doc tells me that it could be as long as a year before my reproductive system gets back to normal. Right about then, I should be starting on Tamoxifen, which should toss me into menopause.

Next couple of weeks, I'll hopefully be getting set up to talk with a radiation oncologist to determine what the length of the radiation treatment course will be. I suspect that just given the way these docs work, plus the intervening holidays, I won't get started until January. Which means this stuff gets done sometime in late February. Aside from the Herceptin treatments, which have me going back to the infusion room once every three weeks until August.

But, at least the folks tell me that radiation is generally well tolerated. Given the early stage of the tumor, I'm hoping they can just target that immediate area and cut down on the skin damage that comes with the treatment.

Week 15

I'm a little late with this update, since I've been working on a couple of deadline projects that need to get finished before Thanksgiving. Sorry!

Monday, thankfully is the day I get my LAST CHEMO INFUSION! Yaaaay!

But this week, the week that's usually my 'feel good because everything's flushed out' week, was not as good as it usually is. The white cell counts are good, thanks to the Neulasta, but my red cells aren't bouncing back. Which equals anemia. Which equals fatigue. I slept more than usual last weekend, including an afternoon nap (and I'm generally never able to nap during the day!), and while I was in pretty good shape on Monday, Tuesday had me zonked from the errands and whatnot I did on my way home from the doc's office.

The doc pointed out the anemia and also suggested that we do another Neulasta dose after my infusion. From what I know, that will only help the white cells, and they seem to be rebounding nicely with the one dose. I'm keeping an open mind about it; since I won't be getting another round of chemo after Monday, we don't have to be concerned about the timing of a possible second dose.

The anemia, however, concerns me. Beyond the medical issues it could present, I don't want to spend the next month feeling exhausted all the time. I've been hibernating enough, and I have work to do. So what can I do about it? I was a little annoyed by my doctor's response - she kind of shrugged and suggested a multivitamin. Gee, thanks, Dr. Obvious. How about nutrition? She didn't jump all over it either way, but what harm could food really do?

I'm still on an unrestricted diet and everything tastes fine, so I stopped at the supermarket and grabbed a bunch of iron-rich foods. I've upped my spinach intake, had a few roast beef sandwiches (which I rarely eat) and double checked the pastas and cereals for their percentage RDAs. I also stocked up on Ensure, the marvelous stuff they tell old people to drink. (For the record, it's pretty tasty in a Vanilla Quik kind of way.) And had a couple of iron supplement pills in addition to my daily multivitamin.

With all that digested, I feel an improvement. I'm not as peppy as I was pre-chemo, but I'm definitely functional without dragging. I'll probably end up laying low over the weekend - no hikes or long excursions - but it seems I might have found a solution I can work with. Hopefully it'll get me through the next three weeks.

Week 14

Went to the doc without the Groucho glasses, got decent news.

The Neulasta is working. Monday's blood test showed that my white blood cell count has nearly rebounded to where it was before I started chemo in August. A bunch of the other things they measure are still down, but at least my defenses against infection are back where they need to be, and that's at the point in the chemo cycle when they should be the worst.

AND, I get to eat raw fruits and veggies again! I celebrated by eating a cheeseburger with lettuce and tomato, with a Caesar salad chaser. I've never been happier to see green leafies.

More good news - the doc gleefully told me that the Neulasta shot should get me through my last round of chemo, too. Hopefully that means that in three weeks, when I'm going through the second week of the cycle, I'll have some energy and will still be able to eat what I want.

But, of course, I'll still feel sucky on Thanksgiving, which is just three days after my last treatment.

Dammit.

I can't find my Groucho glasses.

What?

I've been waiting for a good opportunity to prank my oncologist, and I thought that the checkup after the Neulasta injection would be it. How surprised would she be when she walked into the exam room to find that I'd grown bushy eyebrows, a big nose and mustache?

"Doc, I'm feeling pretty good today, but I have this extra facial hair..."

Week *lucky* thirteen

Lotsa stuff this week.

I never did get back to my usual energy level last week. Over the weekend we were out and about, and I really started flagging at a point. I was just plain weary, so much so that I could have probably called in my blood test numbers without making my weekly visit to the oncology phlebotomist. I was pretty well sure the doc was going to follow through on her previous Neulasta recommendation when I saw her on Monday. And I was willing to listen.

Yesterday came, and while my numbers had improved, they weren't quite as good as they usually are at this point, so yes, the recommendation came in. She told me she'd leave it up to me, so I asked which implications were worse: the side effects from the neulasta or what could happen if I went without. Almost immediately, she said "without." Okay. I guess I can deal with some bone pain. And I won't have to delay my next (and LAST) chemo treatment, which was my biggest concern. There only has to be a 14 day delay, which fits right into my regular schedule. I agreed to do it, so she got me set up to get the shot 24 hours after my infusion.

I talked with the infusion nurse during my treatment yesterday, and she said most people only have the bone pain, and that's easily dealt with with Tylenol and Claritin. (Claritin? Oddly enough, yes.) Always candid, she told me not to freak out and think I'm having a heart attack if my sternum hurts. That, apparently, is one of the big marrow-producing bones, so it's affected by the Neulasta. Great.

Oddly enough, I seem to be a little extraordinary for having avoided neulasta for this long. The doc theorized that I must have "good marrow," and both the infusion nurse and the nurse who shot me up today were surprised I hadn't gotten a shot before.

So, we'll see what this does for me, besides making me ingest more pills. Over the next few days, I'll be popping prescription and OTC meds like crazy to manage the side effects of everything that's supposed to make me better. There's Zofran to keep the post-chemo nausea away, and Claritin and acetominophen to keep away the bone pain from the Neulasta. And, of course, the stool softener and laxative for the constipation from the Zofran and the chemo aftereffects. Go ask Alice, when she's ten feet tall.

I can't wait till don't have to take anything but my usual vitamins. Sometime in the future...


The practice where I go for all of this is a huge medical campus - a mini-hospital of sorts, and I was there for most of the day yesterday. Fortunately, though, the morning was for something fun. A while back the nurse practitioner had told me about a workshop the American Cancer Society runs called "Look Great Feel Better." It covers a bunch of beauty tips geared toward women going through cancer treatment, like skin care, how to draw eyebrows on yourself if you lose 'em, wig and headcovering options, etc.

Oh, and they give you, absolutely free, makeup and skin care stuff worth about $200.

Makeup has never been a big deal for me, and I'm even less focused on it since I work from home, but I'm no stranger to the cosmetics counter for some foundation and nice lipstick. And it sounded like a fun couple of hours, so what the heck? I signed up. Then, a few weeks ago when I went to get my wig at the ACS office, the volunteer told me she would be the lead for the Look Good Feel Better session. I liked her, so I knew it would be fun.

And it was. There were seven or eight women involved, and everyone was into having a good time. It was pretty much like what you'd expect a Mary Kay group session to be like - people poking around the products, joking around about sucking at using some of them (I'm personally awful with eyeliner and avoid it like the plague), and the leader finding something to compliment about everyone's facial features. We shared a couple of war stories, but it was in the course of conversation, not as part of the program. And it was really nice to get positive feedback when I drew in my eyebrows. When I use makeup I'm not accustomed to, I often feel a little clownish, so it's nice to hear when it looks appropriate.

As for the makeup, it was a jumble of different brands - I guess they take whatever they can get from the donors - but we all pretty much got the same product groupings (lipstick, eyeshadow, moisturizer, concealer, powder, etc.). And they were really good brands, including Chanel, Elizabeth Arden, Estee Lauder, Smashbox and so forth. Some are sample size while others are full freight.

Not exactly worth getting cancer for, but a pretty nice gift, nonetheless

I had to laugh when I saw a small tube of Clinique moisturizer lurking in my bag, because back in my late 20s, I had so many of those containers from their bonus bags. My friends and I would trade news of where the latest Clinique bonus was being offered so we could buy the minimum it took to get the bonus bag, just to get the lipstick and mascara. Being young, we didn't need the moisturizer and considered airlifting our collections to needy women in arid countries. I probably still have some around. At the very least, I have the little makeup bags they came in.


But I at least feel as if I'm seeing the light at the end of the tunnel. After this week, I'll have just five more weeks left. I'm handling things fairly decently and making my way through. The next couple of days should be pretty shitty, as usual, but I'm pretty well assured I'll manage my way through without any real problems.