Take Two

Prior to each chemotherapy treatment during this cycle, I had to have my bloodwork done so it was ready for review at my oncologist appointment and I could be cleared to receive treatment. Now that we had gone through one cycle and weeks that followed and we had some time to gather more information as we had more answers, I went into that oncologist appointment with quite the list of questions. Keeping a notebook and a running list between appointments became my thing. A trademark if you will. I love it. I’m not so sure the doctors feel the same way, but I think they are understanding that it is just how I have to deal with things.

My blood work was still not quite good based on the results they had from the lab a few days prior to the appointment. They did redraw my labs and I “passed” to receive treatment. This meant from here forward, I would receive a Neulasta shot to boost my numbers about 24 hours after my chemotherapy ended. Since the meeting with the hospital oncology nutritionist had not been so fruitful, I asked the doctor for some advice beyond “eat healthy”. I wanted definitive answers on soy and dairy. He was not willing to give them. I understand fully that information is constantly changing, but it is a frustrating area for me to this day. Another big topic at this appointment was finding out that there would not be any future body scans scheduled. They consider my treatment “curative” and unless there is a reason to check for something else going on, they tend not to. Stay tuned for how that all turned out in a future post. He did say, at that time, that he would consider doing a scan at the end of my chemotherapy treatments to see how it all looked. I expressed a lot of concern about going off the blood thinner injections I had been on since finding out I was pregnant, unrelated to breast cancer. While in the hospital for That Baby, an OB-GYN doing rounds from my practice had let me know that he felt it would be best to stay on them and I should talk to the oncologist about doing so. The oncologist disagreed and pointed out that even though cancer and chemotherapy are clot inducing, my particular circumstances to be on the blood thinner were hormone related to prevent clots. I was also having pain in my breast and had called about that previously. He did do an exam and determined that it was likely due to the lymph nodes related to pregnancy and lactation my body had gone through. The good news was clear, the exam led us all to believe that the original lump was already much smaller. Whether it was attributed to the one round of chemotherapy or less inflammatory state my body was in post-pregnancy, no one would ever be sure. Either way, I was thrilled!

My husband had accompanied me to the first portion of the morning at the doctor, and a friend was my chemo-buddy for the day. Unfortunately, we were in the wide open side of the treatment area where the chairs sit side by side and go the length of the room. Some people prefer this set up since it is more social. I’m much more overwhelmed on that side, though. She brought magazines, and I had cards. I don’t even think we turned on the television each chair has since we were so busy catching up. The treatment was, happily, uneventful. I left with an appointment to return the next day for my booster shot and a few tricks recommended to avoid some of the nasty side effects it can cause. Unfortunately, since I wasn’t aware until that day, I couldn’t do all the tricks.

The Neulasta shot itself was not too painful. It hurt and my arm ached, but not a big deal the first day. I did take Tylenol and Alavert after I had treatment, the day of the shot, and the day after. I was also taking all of my prescribed medications to deal with the side effects of the chemotherapy I was receiving. The thing with the booster shot, they told me, is that some people can have flu like aches and pains. Some people have severe bone aches the first week. For some reason, to me that meant, within the first week. Well, I started to get achey after about 6 days, but not until that evening. And it was strange. It was in my chest and neck. I was actually concerned it was heart related but my heart rate was fine and it was not painful to breathe. It was like my sternum, ribs, shoulder, and neck bones hurt. By day 7, I was in a lot of pain. By the time it was one week, nearly to the minute, I was in extreme pain in the areas I already described as well as my hips and pelvis. It was a throbbing intense pain that came in waves. It was terrifying. Because of how they described when it typically happens from the booster shot, I really wasn’t sure what was causing this pain. It wasn’t until I called my husband to tell him and let him know I was going to call the doctor that he brought up the shot. I searched the internet for the typical symptoms on some reputable sites, and I had them all. Lesson Number One, that while my doctor and all of them really are really great, no one knows unless they have been through this how it really is. Lesson Number Two, the majority doesn’t always rule and sometimes you just are part of the unlucky percent of people who just get the bad side effects of something. The good news was, since this was a thing for other people, it meant the suggestions to alleviate the pain were also there based on the same people’s experiences. I did them all. I drank a ton of water, I took Tylenol and alternated with Advil, and I got in bed with a heating pad. I couldn’t sit up. I couldn’t lay down. I was kind of propped up on pillows at angle, but even that wasn’t comfortable it was just keeping any supporting duties off the parts that hurt the most. That Guy was single parenting it up that night, checking in on me, and even delivered me dinner in bed once I was able to eat.

The next day, Day 10 in the cycle, was my check in with the oncologist’s office at my Nadir appointment. The way the booster shot works is that it boosts the counts back up, but it can’t prevent them from going low. So all the pain and pressure I was feeling in my bones was literally my bone marrow expanding as my counts went up. So my numbers were still low at this in office check, but I could literally feel the shot working. I also was told not to alternate with the Advil since I was still in the window when I was taking the blood thinners post partum, although they were soon about to end.

During this cycle, I also had my post partum appointment with my OB-GYN. Again, have I mentioned how much I adore that office and that doctor. It was like going in to talk to a friend about just how everything was going and what I can and should be doing through my treatments but she has the inside scoop from my file and the other doctors on the team plus her own medical knowledge and expertise. Additionally, I had my first appointment with physical therapy. Since I was receiving chemotherapy prior to surgery, which is not entirely unusual, but is not the norm from what I understand, no one really knew if or when I should be meeting with them. There are normally lymphedema concerns after surgery, but there are some concerns during chemotherapy. I was told not to carry too much on the side the cancer is on as far as a diaper bag or carrying the kids on that side. I was made aware of what to watch for if I would start to experience lymphedema and the areas where it can happen.

The rest of the experience for this cycle was fairly similar to the first, with the exception of the Neulasta shot. We were able to get out to see my husband play baseball. We met friends at a park for the kid’s to play. I was finally becoming comfortable wearing my wig, except for when my daughter called me out at the dentist. Overall, I would say I was fairing well, and I was six weeks into what was scheduled to be a 24 week treatment plan.