Chemotherapy

With my first surgery complete, and the discovery that my lymph nodes were clear, my oncologist was finally able to give my cancer stage: 2A, which based on size of the lump and the fact that zero lymph nodes were impacted. It's conearly-stagely stage cancer, which is a relief, but wasn't going to exclude me from having to undergo chemotherapy. It's the only treatment available for triple-negative breast cancer, and starting chemo sooner rather than later gives you the best shot of achieving good outcomes.

I don't really know what that means for me, exactly. Given that my lymph nodes were clear and that I had a mastectomy, I'm not sure what they are expecting to find at the end of treatment. I'm still going to have to keep my fingers crossed that I won't have a recurrence - I understand the five-year mark is a good goal to reach, as it will be unlikely I will have a recurrence if it doesn't happen within five years. So... fingers crossed, I guess.

My oncologist described the chemotherapy regimen I'd be undertaking - eight rounds, spaced out every two weeks. The first four treatments would include adriamycin and cyclophosphamide, followed by four rounds of taxol. He also described the common side effects and when I could expect them:

1. Hair loss would begin within the first few days of treatment. I could expect to be completely bald within two to three weeks. 
2. Nausea and vomiting would be the worst two to three days after treatment. 
3. Constipation and fatigue would be ongoing.
4. Some patients also see weakening of the heart, called cardiomyopathy. 
5. Compromised immune system: Chemo doesn't differentiate between cancer cells and healthy cells, and knocks out your white blood cells, which are key in fighting infections.

So I would have to stay away from notoriously "germy" places like:

• Gyms
• Buffets
• Disney World

Guys, you know how much I love Disney, right? My annual pass expired in August - it's the first time I haven't renewed it since we moved down to Florida. And the months of October, November, and December are extra magical as Disney preps for the holidays, so I'm sad to be missing out.

I had also been planning on doing a Disney Halloween-themed cruise to Bermuda with some friends and family in October. Disney Cruises are my absolute favorite vacation, and I had been planning this particular trip with the family since June of 2017. Since the trip was planned for the time right in the middle of chemotherapy, I had to back out of it. Glad the rest of the family still went, though. Wouldn't want my cancer to get in the way of their fun. 

Anyway, as much as the side effects all sound like a blast, I forced myself to look forward to treatment. I understood time was of the essence. The only problem was that I had to be completely healed from my surgery before starting since chemo could interfere with the healing process and put me at increased risk of infection. 

So my oncologist and I set a tentative start date for chemo for August 16, about one month after surgery, to allow time for healing. My husband arranged to be home from work that week so that he could go to that appointment with me... and when the time came, we bravely marched over to the doctor's office together.

Only to have him take a look at my surgical scar and determine I wasn't ready to begin. He postponed treatment one more week, which was unfortunate because Ben would be back on the road for work. And again, I knew starting sooner rather than later was important.

But now that I know how much the side effects kick my butt, I guess I'm grateful that I didn't start on the 16th and got to enjoy my 38th birthday on August 20th pretending to be normal. 

Scary AF

I've been feeling very fatigued lately from chemotherapy. It's even a chore to think about writing. Where did I leave off from two weeks ago? Oh yeah...

Going through a major surgery is scary AF.

I had only ever been operated on twice. I had a tonsillectomy when I was three years old, and
broke my arm when I was six. I suppose I could thank my lucky stars this hasn't been a regular occurrence in my adult life, but forgive me if I'm not feeling in a particularly grateful mood.

There were three thoughts about my surgery that brought tears to my eyes when nobody was looking:

1. Something is going to go wrong during surgery and I'm not going to make it.
2. I AM going to make it out of surgery, only to find that the cancer has spread and my days are numbered. 
3. Even if I do make it out of surgery - and they don't find any contaminated lymph nodes - I still have to go through four months of chemotherapy. Plus I'll never be a whole person again.

 

My husband and I tried to do as many fun things as we could in order to keep my mind off of it. We used up some casino credits for a really nice dinner and some fun at the Hard Rock Casino in Tampa the weekend before surgery. And the night before, I had suggested a Marvel movie marathon - both Ant-Man and The Avengers: Infinity War were in the theaters still, and although we had already seen both of them, I thought it would be fun to stay up all night watching them again. I forgot that we're getting old, though, and only made it through one movie (Ant-Man) before we decided to go home and go to sleep.

My report time to the hospital the next day was 8am. There were three rounds of tears for me that morning - once, right after the alarm woke me and I recalled what day it was. Then again at the hospital as the nurse was prepping me for surgery. My husband and mother were present and it was nice to have the company, but I really didn't want to break down in front of them. I cried a third time after I was wheeled to the pre-op area, after saying goodbye to my husband and mother. Luckily, the nurse in the pre-op area had a really helpful sense of humor. I was grateful for the drugs he gave me to relax me a bit. I remember being wheeled to the surgery room around noon - small, white, crowded. A few of the nurses introduced themselves to me, but that was the last thing I remember before falling asleep.

The next thing I knew, I heard "Wake up, Nicole!" from an unfamiliar voice and some murmuring about getting my husband from the waiting area. I've said it before, but I'll say it again - anesthesia is a wonderful, wonderful thing. The whole operation was a little over six hours and then they kept me overnight in observation. I didn't sleep much, as nurses kept waking me up to check on me, offer painkillers, and other fussing around. I almost didn't want to go home the next day, but they don't usually keep you overnight at the hospital anymore, so I was lucky to at least get one night. Yes, a mastectomy is considered an outpatient procedure these days. Isn't that crazy? Stupid insurance. That's a story for another day I guess.

The good news was that I learned that twelve lymph nodes were taken during surgery, and all of them were free and clear of cancer.

The bad news? Surgery would actually be the easiest part of treating my cancer.