Thursday, January 25, 2007

Looking Towards the Future

Time has gone by really quickly since my last post. Ryan and I went in to meet with the Breast Cancer Center doctor and talked about many things. What we realized is that we haven't really had any time to talk lately, so it made us do that. The big realization that I had in our session is that Ryan and I really don't know what a "normal" relationship is. 2 weeks after we first got together, his brain tumour started to grow again, so we've really been dealing with one of our medical situations since. The doctor reminded us that this kind of constant stress is not normal and that we need to ensure we don't get too caught up in that. The other thing I left the meeting with is hope that there are options out there for us if we wanted to have another child. Of course we have a lot to get through in the next few years, but I just needed to know that there was a door open down the road if we wanted to pursue that.

My mind has been really focused on trying to figure out what my next set of treatments will be like. As I've said before, my oncologist wants me to only focus on what's next, so the last time we talked, it was about my last treatment and not about the next new one. What I do know is that I'm scheduled for February 6th. So, I will go in to see Dr. Webster on February 5th, check that my counts are high enough (I have an extra 3 days to recover this time) and then discuss what to expect over the following weeks.

My next set of drugs are called "Paclitaxel" (taxol) and "Herceptin". Taxol is the one that I am most concerned about right now. This will be the ultimate planners biggest nightmare. Like all chemo drugs, there are many possible side effects, but this one is very unpredictable. My day at the hospital will likely be anywhere from 7 to 9 hours for the first treatment (thanks to my mom who is coming to stay with us). I will lay down in a bed and they will start the IV as they normally do. However, within 3 minutes of my body receiving Taxol, about half of patients have a fairly serious side effect. This can range from extreme vomiting to instant itchy hives on your body or extreme difficulties in breathing. As you can imagine, this makes me more than a little bit anxious!

As soon as a patient starts to get a side effect, they stop the IV and then administer a counter drug to get the side effect under control. Once you are feeling better, they will re-start the Taxol and see if your body can better accept it. Apparently in some patients, it is just too hard on them and they are not able to get Taxol and this will be decided at that time. If I am strong enough, my oncologist would like me to receive 4 treatments in 3 week cycles. The biggest side effect after day one is numbness and tingling in your hands and feet. This is closely monitored as there is a risk that you will experience permanent nerve damage. Once this occurs, the drug is stopped. Another fun thing for me to worry over.

Once the Taxol is is in your system, they then start to administer the Herceptin. This is a drug that I will be getting for the next year in 3 week cycles. There can be side effects after the first 3 treatments, but then your body gets used to this drug and does a fairly good job of accepting it. The things to watch out for usually happen when it's administered and are similar to Taxol's effects. This drug is given in the background and so my oncologist assures me that once I am recovered from my surgery, I can work and live as normal while getting this treatment.

Monday I went for my MUGA Scan. This measures my heart muscle functioning and requires that they inject radiactive substances into my bloodstream and then I sit under a camera while my heart is lit up like a firework show. I should get the results from this test when I see my doctor on Febraury 5th.

Next week I return to work and normal life as much as possible. Being done this first set of chemo treatments feels like a real milestone to me. I am getting closer to the finish line and that feels really good. The current plan is that I finish this next set of chemo treatments in 3 months, then I go for surgery as soon as my counts are strong enough (typically 6-8 weeks after), then I complete my Herceptin cycles and start a drug called Tamoxifen for the next 3-5 years. This is a whole other story that I will leave for a future blog. I want to keep the feeling that I am close to the finish line for now...

Wednesday, January 17, 2007

Information Overload

The fog started to lift yesterday morning and has gotten a bit better again today. On round 3, it started to lift on day 3, so I had high hopes this time, but because I didn’t wait as long to start this round, it had to take longer to get me up again. This week has been filled with appointments, but unfortunately the Monday one I couldn’t get out of bed for. It was for a Muga Scan, which measures my heart muscle functioning. This is one of the more major potential side effects, so they continue with this test to see how my heart is taking things. I have been feeling some aching pains around my heart the past two weeks, so hopefully that is just a fluke (as my doctor says).

Yesterday, I was at the Children’s Hospital to talk to the Cancer Genetic Counsellors. I have decided to go ahead with this process, but it’s quite a long one. It really only involves some more blood from me today, then after about a year of diagnoses, they come back to me to let me know whether or not they found BRCA1 or BRCA2, the two known breast cancer genes. If they do find either, it gives me an increased chance of getting another occurrence of breast cancer in my future or ovarian cancer (over the general population). Because of my young age, they suggested I go ahead with this. Really, it just lets you know whether you need to be more proactive with screening in the future and then they offer the option to my parents and my brother to be tested as well. If I have either of these genes, I got them from one of my parents and they could face the same increased risks (although for men it’s prostate cancer and breast cancer). Each child has a 50% chance of inheriting these genes, so Chad then would also have the option of testing to see if he carried it. They don’t test kids until they reach 18, so Talyn would then also have the option of testing when he was an adult.

Today we go to the Breast Health Supportive Care Clinic. They are a couple of doctors that specialize in Breast Cancer that are there to help if we have other things to discuss that we don’t get to in our 5 minute sessions every 3 weeks with our oncologist. So, Ryan and I are going to talk about what are our options really are if we wanted a second child and what the risks would be. This is a complicated issue and we just want to know the facts so that we can make a decision whether this is something that is an option and if not, then we can stop talking about it so that it isn’t so hard.

With my current schedule, I will be starting my next set of drugs on February 6th, so that means a clinic day on February 5th to check my blood counts. These next drugs sound more daunting the more I hear about them. There are some very serious side effects that can occur almost instantly and then some permanent nerve damage that can result. My dad was really worried about this and wondering why they would want to risk it. I told him that it was one of those things that brings perspective back to how serious this situation actually is. I am doing very well right now, but had I not had treatment things could have progressed in a much different direction. So the doctors really feel that these side effects aren't that major compared with the option of not going ahead and leaving the cancer in my body.

However, all in all I am very lucky and things could have been a lot worse and I thank you all for being along for the crazy ride as we all learn about all the things we never thought we'd have to!

Friday, January 12, 2007

Goodbye to AC

My counts are finally high enough to take another round of chemo. So, today at 2 pm, I will start round 4 and say goodbye to my not-so good friends of Doxorubicin & Cyclophosphamide (AC). It will be a big day for me because it allows me to move onto the next phase of treatment, which will come with its own ups and downs - but it's progress, so I can't complain.

Next week I have a bunch of tests and meetings - they are re-checking my heart muscle functioning on Monday, then I go see some Genetics experts on Tuesday to figure out whether this might impact Talyn and then back to the Breast Cancer Support Center on Wednesday to talk about all the other health things going on with me.

Have a great weekend and hopefully I'll be back on my blog soon - which means that this round went better than expected!

Tuesday, January 9, 2007

Another Lesson in Patience

The hospital just called and my counts have dipped to 0.9, so even lower than my last round. My amazing nurse Linda also knows how important getting this done this week is, so she has rescheduled me for Friday with hopes that my counts will be at least 1.2 by then. I wish there was something that I could do to make a difference, but my doctor says there isn't. I had heard from another doctor that there might be something they could give me to help my counts rebound faster, but Dr Webster told me yesterday that unfortunately isn't an option.

Although I am a planner, it is a definite challenge to continuously replan all the aspects of our life around this uncertainty: Ryan runs his own business and has to continue to reschedule client meetings, we have to change Talyn's daycare schedule, we have great family who have offered to come out and help, but we never really know when that is, my team at Long View makes whatever time I have for them work and our amazing friend Erin across the street continues to leave her life open for Talyn to drop in when needed.

Thank you to everyone who continues to change their lives because of our schedule, we appreciate it more than we can tell you!

Monday, January 8, 2007

What Does Normal Feel Like?

Although I thought that I felt much better than last time, my counts didn't agree. My netrophils were once again only 1.1 and they needed to be at least 1.5. Dr. Webster could tell that I was very anxious to get my fourth cycle over, so he offered me a couple of options - which I took him up on.

I will go tomorrow morning to re-check my counts. If my netrophils are at least 1.2, then I can still go ahead with treatment tomorrow afternoon. Although I will have to be extremely careful throughout this cycle because my counts will likely be completely wiped out. If my counts are not high enough tomorrow, then I will go and re-check them again on Thursday and then potentially get treatment on Thursday afternoon.

If all of these options don't pan out, then I am again delayed one week. Which brings me back to my title - I clearly have no idea what normal even feels like anymore!

Today is the Day!

It's funny how many of the people that I talk to ask how far along I am. When I say that I've finished 3 out of 8 treatments, they are always amazed at how quickly it has gone - they say that they feel like I just started. I however feel like I've been doing this forever!

Today I go get bloodwork at 2 and then meet with my doctor at 3 to review my counts and ensure they are high enough for tomorrow's treatment. I do feel stronger than the last time I did this, so that is a good sign. But mostly I really want to get tomorrow's treatment over with so that I will be 50% done! I think it will be a real milestone for me.

Last week I was talking to my boss at work and he was asking me if I now felt more confident in my ability to get through my treatments and I absolutely do. Shortly after my first treatment, I was laying on my bathroom floor and thinking that there was no way I could do this 1 more time, let alone 7. Now however, I have gotten used to the feelings that these drugs give me, I know what drinks and food I can keep down and Ryan knows when he should and shouldn't talk to me - ha, ha.

Most of all, I know that I will get through this set of treatments very shortly and then will turn my focus onto my next set of chemo drugs and the side effects that I can expect from them.