Hmmm. I'm not even sure where to start. I guess, the greatest thing is that I stood up for myself and said I wanted the blood draw done in my hand/arm because my port area hurts so bad. Done. But, I have to prepare myself for my next chemo because that will need to be done through the port. I have a cream I'll apply to the area 45 minutes prior to the chemo session that I hope will do its intended job and numb the area. Really, I am not afraid of needles - I even have to watch them doing the draw - the port just HURTS.
So, a nurse practitioner met with me about 20 minutes later and told me my white blood cell counts are already critically low. Big bummer. Normal range is 3.9-9.0 K/uL and mine was 1.4 K/uL. My neutrophils were also a concern and very low. Normal range is 1.7-8.0 K/uL and mine was 0.5 K/uL. I have a copy of the lab work and other things are low as well, but these two are the ones they were the most concerned about.
White blood cells race to a site of infection and fight it. Neutrophils are a form of white blood cell that eat pathogenic cells. So, my ability to fight of infection is greatly compromised. I immediately wondered if I need to start wearing a mask. The NP read my mind and said I don't need to take that precaution yet. Just avoiding large gatherings and step up my hand washing. I work in public health and during H1N1 talked often about the importance of hand washing; she was preaching to the choir...although she would have cringed had I started to sing!
The next topic in my long list prepared last night for the appointment. Tackling the side effects from the anti-nausea medications. I'll only take Zofran next time and see if that does the trick. Apparently Compazine is well-known for my chief complaints.
Then, my sore throat and heart burn. The NP said I'm already exhibiting signs of esophagitis. I mouth sores and a pretty inflamed throat during my exam. She prescribed "miracle mouthwash" for me. It's a mixture of lidocaine, maalox, and benadryl. I tried it with lunch (the only shots I'll be drinking for now) and it made my lips and throat numb. Very odd feeling. The staff at Maag's, (love you guys) told me to carefully chew my food while taking this because it will affect my gag reflex and I could choke. I joked with them, "great, I have cancer, but I might die because I choked on a piece of steak." Note: another bucket list item is to be a stand-up comedienne. She also said people my age suffer from chemotherapy side effects moreso than a 70 year-old would. Strange. I would think younger people's immune system would conquer better. She actually said the little pediatric kids suffer the worst. So sad. But, the point is, chemo is doing its work and I'm getting sicker. Is it strange that I'm glad? It means the chemotherapy is doing its work. Killing good cells and bad.
Next, I asked for dose-dense chemotherapy. It was talked about in the appointment when I was told the of my chemotherapy options. I have a TNBC sister in Texas that started chemo five days before I did, and gets chemo every two weeks vs. my every three weeks. The oncologist, now also meeting with me, agreed we can go this route. My next chemotherapy has to be three weeks from my first, but after that I can schedule them every two weeks. I will have my second round on August 23rd. On August 24th, because of my low white blood cell count, I will receive a shot named Neulasta. It must be a wonder drug, because it ranges from $8,000-$10,000 per shot. I cringe, cringe, cringe regarding financial costs, but this is my life we're talking about.
They are now going to start making arrangements for Hereditary Breast and Ovarian Cancer (HBOC) testing. As per its name it will determine if I carry genes for breast and ovarian cancer. Part of the tests will show if I'm positive for BRCA-1 and/or BRCA-2. If so, I would likely opt for a bi-lateral mastectomy and have my ovaries removed to reduce my chances for recurrence. I will weigh those options carefully and meet with genetic counselors. We'll see.
I think that sums up the appointment. Afterwards I had to go to the hospital and have an echocardiogram (ultrasound of my heart). Adriamycin, the red devil, can damage my heart. The ultrasound technician gave me a great compliment. She said my heart was very photogenic! NICE! She had a hard time seeing my endocardium, so I had to have a dye inserted through an IV to light things up a little more. It was wicked cool to see the valves in my heart flapping away. I thought they looked like turtle legs swimming. Hopefully no damage comes to my strong heart.
I took the afternoon off and slept for hours. A bit overwhelmed with the results and information learned today. I know I need to buckle down, work to keep germs/infection at bay, and stay rested.
So, a nurse practitioner met with me about 20 minutes later and told me my white blood cell counts are already critically low. Big bummer. Normal range is 3.9-9.0 K/uL and mine was 1.4 K/uL. My neutrophils were also a concern and very low. Normal range is 1.7-8.0 K/uL and mine was 0.5 K/uL. I have a copy of the lab work and other things are low as well, but these two are the ones they were the most concerned about.
White blood cells race to a site of infection and fight it. Neutrophils are a form of white blood cell that eat pathogenic cells. So, my ability to fight of infection is greatly compromised. I immediately wondered if I need to start wearing a mask. The NP read my mind and said I don't need to take that precaution yet. Just avoiding large gatherings and step up my hand washing. I work in public health and during H1N1 talked often about the importance of hand washing; she was preaching to the choir...although she would have cringed had I started to sing!
The next topic in my long list prepared last night for the appointment. Tackling the side effects from the anti-nausea medications. I'll only take Zofran next time and see if that does the trick. Apparently Compazine is well-known for my chief complaints.
Then, my sore throat and heart burn. The NP said I'm already exhibiting signs of esophagitis. I mouth sores and a pretty inflamed throat during my exam. She prescribed "miracle mouthwash" for me. It's a mixture of lidocaine, maalox, and benadryl. I tried it with lunch (the only shots I'll be drinking for now) and it made my lips and throat numb. Very odd feeling. The staff at Maag's, (love you guys) told me to carefully chew my food while taking this because it will affect my gag reflex and I could choke. I joked with them, "great, I have cancer, but I might die because I choked on a piece of steak." Note: another bucket list item is to be a stand-up comedienne. She also said people my age suffer from chemotherapy side effects moreso than a 70 year-old would. Strange. I would think younger people's immune system would conquer better. She actually said the little pediatric kids suffer the worst. So sad. But, the point is, chemo is doing its work and I'm getting sicker. Is it strange that I'm glad? It means the chemotherapy is doing its work. Killing good cells and bad.
Next, I asked for dose-dense chemotherapy. It was talked about in the appointment when I was told the of my chemotherapy options. I have a TNBC sister in Texas that started chemo five days before I did, and gets chemo every two weeks vs. my every three weeks. The oncologist, now also meeting with me, agreed we can go this route. My next chemotherapy has to be three weeks from my first, but after that I can schedule them every two weeks. I will have my second round on August 23rd. On August 24th, because of my low white blood cell count, I will receive a shot named Neulasta. It must be a wonder drug, because it ranges from $8,000-$10,000 per shot. I cringe, cringe, cringe regarding financial costs, but this is my life we're talking about.
They are now going to start making arrangements for Hereditary Breast and Ovarian Cancer (HBOC) testing. As per its name it will determine if I carry genes for breast and ovarian cancer. Part of the tests will show if I'm positive for BRCA-1 and/or BRCA-2. If so, I would likely opt for a bi-lateral mastectomy and have my ovaries removed to reduce my chances for recurrence. I will weigh those options carefully and meet with genetic counselors. We'll see.
I think that sums up the appointment. Afterwards I had to go to the hospital and have an echocardiogram (ultrasound of my heart). Adriamycin, the red devil, can damage my heart. The ultrasound technician gave me a great compliment. She said my heart was very photogenic! NICE! She had a hard time seeing my endocardium, so I had to have a dye inserted through an IV to light things up a little more. It was wicked cool to see the valves in my heart flapping away. I thought they looked like turtle legs swimming. Hopefully no damage comes to my strong heart.
I took the afternoon off and slept for hours. A bit overwhelmed with the results and information learned today. I know I need to buckle down, work to keep germs/infection at bay, and stay rested.
You are such a GREAT writer and this blog is AWESOME!!!
ReplyDeleteFIrst off I am so glad that they are giving you Neublasta..my sister the Onocology nurse says that this is a GREAT thing to do and even though it costs it is a blessing!!!
Miss Avery and "Miracle Mouthwash" are GREAT friends...I have also tried it and it does give you a weird feeling but it calms things nicely!!!
Last time Avery was in the PICU we were with the cancer kids and I have to say that my heart ached for those kids and they took it so well......tough.
I think you and Avery also have something else in common....germ control and staying away from crowds and groups. I also laugh when the doctors tell me....wash hands, wash hands, wash hands and that kids are germ factories....it all sounds a little familiar with my past background!!!! But I appreciate the way they say it!!
I am working on your lanyards and we pray and think of you often...stay strong my friend!!!
Also let me know about the genetic testing!!!