Chemo #3 (Cycle #2A)

Day 3 of Cycle 2A and I'm feeling not so bad. I really think coming down with the cold last time made it much worse. Day of chemo as was as expected...sort of like a terrible hangover without the feelings of self-stupidity! So they used the port for the first time and this seemed to make it all go a it quicker and no funny vein spasms. Using the port also means I feel the effects much quicker. The Benadryl (pre-chemo meds) through the port was almost instant head spins and wooziness.....can barely keep an intelligible thought for a little bit and have trouble putting sentences together! It is pretty short-lived and by the time the 4 chemo drugs are in me I just feel tired and headachey.

I chatted with a few other patients this week. It's sort of like being on a plane on your own. It's nice to have a little conversation with your neighbour but then you don't want to feel compelled to keep up the conversation the whole time....especially if you just want to close your eyes. Heard about the "Cottage Dreams" program where people have donated a week of their cottage time to cancer patients who have completed their treatment. Interesting concept but I doubt we would do it as: 1) Steve's bro has a cottage we can use and 2) dogs aren't allowed :( Saffron would be sooo hurt!

Another interesting observation from my time in the chemo suite this week, there was a man who I believe was on his last and 12th ABVD treatment and he still had his hair!! His family (8 and 10 yr old sons) was there to see what dad had been through and how it all worked. We had thought that we may bring the girls to see in the summer when they are out of school. We'll see.

So my dad is here and has been dinner cooker for the last several nights and took Wynne to gymnastics on Tuesday. Steve had another open house last night so it's been great having him here. Today I had a follow up doppler ultrasound on my left arm. It feels pretty normal now so it must have just been some sort of vein irritation from the chemo into my arm. Hopefully it won't come back now that the port is being used.

Have had a few waves of nauseousness today and felt pretty wiped out this aft so I did have a nap. Hopefully tomorrow will just be more of the same or better!

On the lice front we have continued to wage war on them all week. Wynne passed the inspection at school on Monday but Avery didn't and I had to bring her home and pick more nits all morning and then again that night in hopes that she would be okay for her next day of school on Wednesday....and yeah...she passed! Steve is now a master nit-picker....way better than me I think. We figured that between the two of us we likely pulled off well over 100 nits from Avery. We think she was likely ground zero! The school has a bit of an epidemic with it right now from what we hear. Wynne's best friend also had them and another girl in Wynne's class got sent home....I think they should check Avery's class a little more closely! Avery announced after school on Wednesday that she told EVERYONE she had lice....great...at least she's not self-conscious! Hopefully we will be all done with them by next week after we do a second treatment on Saturday to make sure we catch any that have escaped the first treatment!

My Little Window

So since about Wednesday I have felt pretty much my self again. So this is my little window of normalcy. Sort of. I did end up having a Doppler ultrasound and seeing my oncologist on Thursday as after several days of weird feelings in my left arm (the chemo side) I decided to mention it to my nurse on Wed and see what she thought...this turned into the ultrasound to check for blood clots...they don't take any chances. It's a hard feeling to describe...a sort of weakness and achy discomfort from my shoulder to the tips of my fingers. Definitely worst at night especially at 3am when it wakes you up and you wonder if you are having a heart attack! So they said I was right to mention it. So the conclusion is no apparent sign of blood clots (whew!) and no real explanation (a perplexed look from my oncologist). Possibly some vein irritation /inflammation from the Dacarbazine? If it is still there next week they will do a follow-up ultrasound that has already been scheduled for Thursday.

So these few days of feeling good before Tuesday when I have my next chemo, have been fairly relaxing...just trying to do some catch-up around the house...although my catch-up got sidetracked into cleaning out our closet in our bedroom....I told my mum it must be a sign of dealing with inner turmoil since I wanted to clean out a closet no one sees when the very visible living room toy area and dining room are a complete disaster!! Ah well. So part way through this late yesterday afternoon, Avery gets up from an unplanned nap (great for those nice early bedtimes!) and complains that her head is itchy. Well I probably would not have thought much of it except that morning I had been examining my thinning hair and pulled a small dark thing out with a piece of hair. I carefully examined it and decided it might be a dead hair follicle.....now I gave this a second thought!! So I sat her down under the bright lights in the bathroom and started sifting through her hair. Lo and behold I found nits!! AAAGGGGGHHHH! I would not have known what I was looking for as we have...very luckily...been spared from this so far (even though the "Lice has been found on a child in your child's class" info sheet has come home on a semi-regular basis since Wynne started JK). However, I had the extra special opportunity of watching someone else nit-pick through a little girl's hair at Wynne's Sparks camp last June. One unfortunate girl had been sent home after the mandatory lice inspection......came back later that night supposedly treated and left by her grandparents only for the nit experienced leader to find many more nits and even a live one in her hair. So lucky me....I now knew what to look for. I figured that was one piece of knowledge that may just come in handy some day! So Avery had headlice.....check the also semi-napping on the couch Wynne....found a LIVE one!!! Off to Shopper's....bought the more expensive non-pyrethrin based stuff the pharmacist recommended and tried VERY hard not to scratch my head while in the store and definitely not while at the cash where the checkout girl reached for her head as she looked at the box and then (really!) did a quick head scratch and promptly stopped. Lovely...I'm contaminated even more now! So the evening was spent stripping beds, bagging toys and other things, applying solution to ALL of our heads (the result of Avery and sometimes Wynne regularly sneaking into our bed at night)....none of us were spared. The girls didn't get to bed until almost 11pm...good thing they napped. Today (and every day for the next 2 weeks) we have to do more nit-picking and then repeat the treatment next Saturday. For you lice virgins out there, the treatment does not kill the eggs (only the live ones) and these are glued to the hair shaft.

So I actually considered cutting my hair all off right then and there but Steve wasn't up for it. He wasn't ready to give up on my hair quite yet...maybe by the end of the week it'll be gone anyways and I won't have to re-treat! Avery has wanted her hair cut up to her shoulders so I DID that before we treated which will make the nit-picking easier and meant not needing as much expensive solution. We will have to take her to First Choice to get it tidied up I'm afraid....it's not too bad but a little shaggy at the back. She loves it though!!

So my little window has now been filled with nit-picking! Some of you may be wondering what I have done work wise. Since I was already on part-time/flex I didn't really need to do much. I have been trying to wrap up a few of my projects but have been finding it tough with appts and everything else. Luckily it is for a relatively laid back and otherwise busy with other things client. I will still do a few hours here and there and then try and made a clean leave-of-absence break for the summer so I don't feel like I have to check my work e-mail as frequently. Actually I have found it really tough to keep focused on work. It just doesn't seem that important right now and I just don't want extra stress in my life. I may be able to collect 15 weeks of EI for sick leave but it won't be much with my part-time hours....at least it would be something. Things will be tighter but we'll be fine.

So that's my week...pretty good compared to how I felt last Sunday and.....my cold did go away by Monday morning! I was very pleased and kind of amazed! I went to a "Look Good Feel Better" workshop on Tuesday. I had fun but when I came home all made up (the focus is tips for keeping up your appearance during cancer treatment if you are not familiar with it) I had mixed reviews. The girls thought I looked pretty.....they are such girly-girls and just love make-up...not sure where they got this from....not me! Steve on the other hand felt I didn't look like myself and wasn't so impressed :( The best tip was for drawing in eyebrows...hopefully I won't need that but now I am armed and ready. I got some great makeup tips and came home with a box of comestics and extras to play with. I have never really learned how to put on make-up so I really did learn a few things and maybe I can keep up appearance a bit better now and draw attention away from my lack of hair (or scarf, hat or wig??) and make my my eyes POP! :)

So appointments with the oncologist and bloodwork on Monday and chemo (using the now healed port) at 9am Tuesday morning. My dad is coming on Monday and will stay until Wynne's gymnastic "Springfest" show on Saturday and help take care of all of us this week :) I basically have family booked to come for the next 4 treatments. This is what the summer is going to look like! We feel so supported by friends and family!! Thank-you...thank-you...thank-you. I'm going to be saying this a lot.

General Malaise

This is how I have been feeling since chemo#2. On Thursday morning my nose started running on and off and then by Friday night it felt like a full on head cold...no temperature luckily. My fear is of course...how long is this cold going to last if I have a weak immune system!? 6 months!!? I hope not. I think I would be feeling pretty good without the cold. I was feeling a lot more nauseasness (than last time) on day 3 (Thurs) and it sort of came in waves but nothing I felt I needed more drugs for (I do have another drug to take if needed). I have also noticed that I do best if I don't wait too long between snacks.

I have been doing more research into natural supplements...lots of conflicting info out there (of course!)....mostly whether you should take antioxidants or not in case they help the cancer cells too. I wanted to figure out any way to help boost my white blood cells (WBC) but the main recommendation (Polerga - pig spleen extract or peptide - ewww!) is super pricey and as with most natural supplements the scientific evidence is dicey. Often chemo patients are given neupogen or neulasta shots to help WBC counts (I haven't been) and I asked my oncologist about this at my last appt and she indiciated that recent (last several years) it has been found that these shots increase the lung toxicity effects of the Bleomycin (the B in ABVD) and therefore are not being used for cancer patients taking Bleomycin....so I guess it's just up to my own bone marrow to get busy! Now to kick this cold!

My hair is thinning. I don't think I will be saved from this particular side-effect. I can take out small fingerfuls if I run my hand through my hair.....not crazy but definitely NOT normal daily hair loss. I think I am prepared..if not particularly happy about this particular aspect of the chemo. It's just hair...it'll come back! Also I keep hearing that it may come back different at first...curly or darker (please less grey!). That would be weird!

Once again thanks to all of the kind words of support I've received this week. It is truly, truly, appreciated. I do apologize for dropping this on some of you while at work and distracting you from your tasks at hand! No reading blogs while at work!! :)

Treatment #2 (Cycle 1B)

So in for bloodwork at 8:20am yesterday and chemo at 9:50am. It was all a bit delayed because the bloodwork results were late and when they did arrive my white blood cell count was below the normal go ahead so they paged my oncologist to get the go ahead and she said do it anyways...so I must be extra careful to not expose my self to sick people or infection of any kind because my immune system is already pretty wiped out. They couldn't use the port yet, still a bit tender and what a lovely bruise! No low cut shirts for a little while I guess ;-)

So they managed to find a co-operative vein near my left wrist. The pre-meds which includes Benadryl (for my lungs) totally spun me out. Otherwise it went as planned. Steve brought me lunch and hung out with me at the end and took me home and I was home by just after 2:30pm. Lots of people come and go in the Chemo Suite (in the Grand River Regional Cancer Centre or GRRCC). There are two big rooms full of beds and recliners. Both times it has been pretty full....mostly seniors...so I can't help but feel a bit tragic usually being one of the youngest there. There are a few other younger people. I saw a brand new mum with babe in arms...I'm pretty sure she was there to be treated not just visiting. Now that I can't imagine.

So far it has been about the same as the last treatment. I was totally wiped yesterday when I got home and slept for several hours. Thought I would get to blogging right away....but there was NO way. By the evening I was feeling pretty normal again. Today has been pretty good. I totally took it easy and tried to catch up on some long overdue e-mails (as many of you found out). Steve's parents are here and it has been fantastic having them...we realized when my mum was here last time how essential the help is around chemo day. Just to do dinner and get Wynne from the bus, take Wynne to gymnastics, Avery to the park etc. Today Steve's mum has dinner all ready and they took the girls to the library after school. Especially great as Steve had another open house tonight (3 Weds in a row!).
We have had so many generous offers of help. Thank-you all so much for your offers and positive thoughts....we just don't know what the next few months will bring! I've realized how so many of our friends are really very positive people. We have had family here for us thus far. My dad plans to come for the next chemo day on April 27th. Hopefully I will still have hair in another 2 weeks! :) Staying positive,
Jenn%)

Porta-Cath Insertion

So today was my port insertion. I had to be at the hospital at 7:15am (no breakfast :() to register (even though the nurse's station I then had to report to didn't open until 7:30am) and had stayed out later than planned the night before having dinner with friends (and breaking the news).

They of course had to take MORE blood today (they didn't test for all the things they needed today on Tuesday when I gave blood...of course). The right arm was unsuccessful today so she drew from just above my right knuckle! Argh! This port should make all of this a bit easier! So I was prepped for the insertion which actually considered minor day surgery. I was given a sedative to relax me...very good! Prep...like surgery, 3 nurses and the radiologist doing the insertion. The nurse showed me what a port looked like..sort of amond sized with a tube that is inserted into a major vein in my chest. The top of the port has a 1cm dia membrane that needles can be inserted and this is all under the skin so it will just be one little prick to access it.

The whole surgery was weird because I was awake but well frozen...but I could feel all the tugging. Just near the end before suturing I had a pretty weird experience...I think my body was considering shutting down (I had something a bit similar with the biopsy in February)....the room started to spin and disappear and then tears started streaming down my face! I did not see that coming! It's not like I was sad..it was a physical reaction! I had been chatting with the nurses. They were all really nice and I think tried to keep me chatting to keep my mind off of what was going on. I told them that if/when I lost my hair I was hoping it wouldn't come back grey! They thought that was pretty funny (and said wasn't I too young to have grey hair...I wish). They were also all very interested to hear what I did for a living....assessing risk of people getting cancer from contaminated sites...ironic eh! I came out of there feeling pretty peaceful actually....partly because everyone was so nice. Gobbled down my snacks and juice and then had a nap until Steve picked me up.

At home I slept most of the afternoon...I was pretty groggy. I feel okay now but am guessing might feel a bit sore later. The dressing is huge! It is also a pressure bandage so I can't turn my head because of it and still have pinky prep stuff all over my neck. The made 2 incisions to put it in the port, one on my neck and one on my chest. I am supposed to have the dressings on for about a week and they may not be able to use it for Chemo this Tuesday :( We'll see I guess.

So far...not too, too bad

So day 6 since chemo on Tuesday and I am feeling not too bad. Still seem to get tired quickly and I seem to be more winded going up the stairs (especially carrying a sleeping 4 yr old!). A few weird aches and twinges... but okay. I am hoping that the 2nd week of the cycles will be better however I am anticipating that it may get worse later on as the chemo takes more of a hold. The neatest thing is that the swollen nodes on my neck (or tumour that is) has already gone down noticeably. They said it would be fast. I am not as self-conscious already. This is good if my hair does fall out since my face won't look as puffy! My hair is feeling a bit weird and dry to me and I am totally paranoid about brushing it.

So although I don't have my next chemo until Apr 13th I still have to go into the hospital 3 times this week! Tuesday to give MORE blood so they can check electrolyte and potassium levels (while the tumours are breaking down fast) and on Thursday (at 7am or something crazy) to get a porta-cath put in and on Friday to meet with my oncologist (to see how I have coped and check on side-effects). The port will save my veins some trauma...I have a lovely bruise from the chemo injection already. The port will be implanted under the skin and go into a major vein....I have been told that it will just look like a button. They will use this for most injections from now on.

We have now spoken with the girls....we sat them down last weekend. They took it in stride. The C word doesn't mean the same thing to them as it does to everyone else. The hair thing is what worries them most I think. They might be a bit sad that mummy will be more tired than usual and might not be able to do as much with them as normal. Basically what they understand is that mummy needs many months of strong medicine to make her better again.

My mum was here most of this past week and it was a big help and great to have her visit...hugs to mum!!

And so it starts

First day of chemo on Tuesday. It all progressed very quickly since my appt last Friday (compared to the rest of the process). I was told the first treatment might not be too bad. So far so good. I was really tired when I got home on Tuesday and napped on the couch. It all started at 8am on Tuesday with the bone marrow biopsy....what fun. Apparently my bone marrow "liquid" was not co-operative after my Dr tried 3 times to get some. She let it go because she got a good marrow core sample anyways. Had the talk with the pharmacist about all the possible side effects of the many drugs. 4 chemo drugs (A.B.V.D), 2 prescription that I took 1st thing that day (1 for nausea and allopurinol to help flush dead cells out to prevent gout) and then I found out that I would get another 3 in an IV just prior to the chemo drugs (benadryl, hydrocortisone and another anti-nausea drug)....that a total of 9 new toxic substances in my system on Tuesday!
So the plan right now is 6 cycles of ABVD, that is equal to about 6 months of chemo. Every other Tuesday will be my chemo day. Yesterday I had a MUGA test (heart function)...for a before picture as one of the chemo drugs is hard on your heart. Next Thursday I am scheduled to have a porta-cath put in so they don't have to inject into an arm vein each time. I see the oncologist again next Friday to check in before the next chemo day and see what sort of side effects I have had. She will also have a better idea of my staging we hope and have the results of the bone marrow biopsy. The Dr thinks I am likely somewhere between a II and III but the CTscan wasn't clear and she wanted to consult further with the radiologist. Some nodes around my back may have been involved?

Yesterday (day 2) I was suprised how good I felt. I actually walked a bit much (walked Saffy in park, walked home from hospital and then over to the office and Shopper's) and was pretty wiped by late in the afternoon. I felt a bit crappy when I woke up this morning (day 3) but not so bad now. Vikki the pharmacist said that day 3 and 4 are sometimes the worst for people. We'll see.