Chemo Round 4

Chemo round 4 did not quite go as planned. My liver enzyme AST was actually even higher, at 115 when it had been 105 the day before. My dr reduced the first component of my horrible cocktail, the Taxotore, to 60%. Everything else stayed the same. I was horribly anxious to the point of frequent tears.

We got my echo back midway through the first drip, and my heart is in the normal range at 65-75% ejection fraction, but it was 55% when I started. No idea what is up with that. Maybe an athlete heart to start, and now I am just normal? Sometimes my heart pounds as if I had just sprinted a mile, even when I am lying in bed doing nothing. It didn't used to do that before (except that time I double dosed on Sudafed, which is at least explainable).

We don't have the MRI back yet. I should get that today. If the chemo is working, I am terrified of changing it. Heart damage or liver damage is pretty bad, if that is where I am headed, but I would rather have that over not getting all the cancer or it coming back.

This morning and last night, I ate. My digestion was normal. I am very nauseous, but pretty sure that is nerves. When I left chemo last night, they gave me a huge push of Ativan, an antianxiety med, that made me feel dizzy, tired, and weak. As if I had been roofied. My hands are shaking this morning and I am already teary.

I am terrified of what my surgery prep appointment today is going to be like. Losing my hair was one thing. It will come back. Losing a breast, or even part of one, is much more terrifying, and permanent.  I really just hate this. It seems so unfair and genuinely, unavoidably horrible, whichever choice I take.

My sister came and we had a great time flipping through fall fashion mags. I wore wig 2 as a trial to a very positive reception. I even took it off to show two newbies who had just started and could not believe it was a wig.

My nurse Chelsea introduced me to a woman who went through my exact chemo protocol, which is generally accepted to be one of the more brutal ones. People are often delayed or see a dose reduced. The patient, Julie, said chemo was much worse than either surgery or radiation. I also found a CrossFit coach in Baltimore who trained and opened a box while undergoing treatment. That helped.

At the prechemo appointment with my medical oncologist, I described my tumor size as having shrunk from a small plum to a jumbo Spanish olive. She wasn't familiar and asked how that compared to a Kalamata, so we got her a jar and brought it the next day. She actually stopped by to say thank you and that it was one of the most thoughtful gifts a patient had gotten her. I hope that tumor keeps shrinking. To an olive pit, to nothing!

I know I have to have some kind of a surgery no matter what, but the statistics are dramatically better for neoadjuvant chemo patient that get a complete pathological response, ie, at the time of surgery, pathology cannot detect a single surviving cancer cell. Odds are good without that, but for 5 years out. I want to live another 50/60/70+ years! The great numbers you see at 5 years deteriorate the farther out you get. That's one reason why I am so fixated. Chemo is awful, not just the day of the infusion, but the entire 4 months of prep and infusion I have already been through. I don't know if I could bear to do it again, which is why it is so important to me to get the very best result I can... so I never have to do this again. I know I will survive this, and that belief is still so strong, but it is living with the constant background of fear and dread for how I will be living my life that is really hard. 

9/10 was chemo rd 4. 

Today, 9/11, I am going to try to remember that there were some who gave all to other evils in this world. Every day we live, proudly and with compassion and grace, we fight back. Let us never forget their sacrifice, or that the price of freedom and security is vigilance and deterrence. As hard as it feels going through cancer, I want to be back at work and fulfilling a purpose in serving others. 

On to the next appointment!