Another Round of Chemo... Done

I had blood labs, a follow up visit and chemo yesterday. My white blood count was down a bit but it wasn't down enough to stop my chemo. (Thank goodness!)

I asked to stay on a 75% dose of Taxol since I still have tingling, albeit not bad, in my feet. I was informed that they would keep me at this level from now on. I'm glad to hear that... It eases my mind since I was so concerned about permanent damage to my nerves.

They started me back on the daily dose of Lapatinib. Fortunately, my dose is now 2 pills instead of 3 each night. Even so, before taking the pills last night, I paused, realizing that my stomach issues would get worse again... But, hopefully, a 3rd less of the dose will help in that area... So, down the pills went. (I can feel the crampiness a bit this morning. But, nothing is too bad yet.)

On a happy note, I'm glad to report that the peach fuzz on the top of my head is getting fuzzier. I'm very thankful for that...

On my next set of "to dos" is finding the best surgeons for the surgery I will have in February... I'm still waiting to hear back about the plastic surgeon in Chapel Hill who will put in the tissue expanders after the general surgeon does my mastectomy... Hopefully, I can get an appointment with that one soon!

I have also done some limited research on reconstructive plastic surgeons for my final surgery. The best work I have seen is from a doctor who is all the way out in Beverly Hills! That's not so convenient... But, I want the best even if he isn't in my network... We'll see how cost prohibitive (out of network, flights, hotel) that will be... But, I'm shooting high since I plan to be here until I'm old and grey!

Yesterday's Chemo

My mom took me for my all day outing at the Regional Cancer Center yesterday for blood work (8:30), doctor's appt (9am), and chemo (11am-2pm).

I have a little bit of a cold but my blood counts looked good. (Yay!!)

We met with Cindy (the study nurse coordinator) and Dr. Rubin. I described my concern that the tingling got worse last week even though I didn't have chemo. Luckily, three days ago, the tingling got MUCH better. It was no longer driving me crazy.

We also discussed the hives. We all believe that the 3 Lapatinib pills I was taking nightly caused those. So, this is what we decided...

We would go ahead with chemo. A full dose of Herceptin (hooray! my favorite), 75% of the Taxol (I'm glad he reduced the amount) and one more week off of Lapatinib (which my stomach appreciates the continued break). Next week I'll probably start back on Lapatinib with 2 pills instead of 3. Hopefully, that will help.

I had the best chemo room available yesterday... the one with two big windows and a bed. My mom loved the windows. And, she even napped with me for a while. (The benadryl is still too much to even fight. Sleep overcomes me!)

When we got home, I slept some more. But, forced myself to wake up for Regan's 6pm dance class. She got to wear her Halloween costume and they performed a couple of dances for us. My favorite was the Monster Mash routine!

Except for waking up with a headache, I feel fine today. And, was able to to find some fun socks for the kids to wear for "Crazy Sock" day at school.

I'm so glad my parents are here... It is so nice. Plus, it's a great week with all the fun Halloween/Fall festivities going on! The Wizard of Oz trail and trick-or-treating is coming up on Saturday. What a fabulous line up for their last day here!

Last Week...

Last Tuesday, I went in for chemo and was rejected... Yes, I still had (and still have almost another week later) tingling in my fingers and toes. But, that wasn't why they told me I couldn't have chemo.

The night before, my legs, stomach & back broke out into hives. I think it is from the lapatinib pills that I was taking nightly. Those caused the rash on my face and the stomach issues. So, I blame those pills. But, they decided that they should follow protocol and take me off of all chemo drugs for a week. (I really wanted to at least get Herceptin. That is probably the best drug I'm on with the least side effects. But, the answer was "no"!)

Instead, I had to take meth prednisone. (Yuck!) I had to take 6 pills on the first day and it made me dizzy and hot. Plus, those pills make you look puffy. (And, I don't like to look puffy!) Thankfully, I finished the pack of pills yesterday.

I have chemo on my schedule for tomorrow. But, first, I'll get some bloodwork tests done and meet with my doctor to discuss what we are going to do. I still have tingling in my hands and feet. But, it's not as bad as it was before. (Although, tingling for three weeks straight isn't a good thing.) I'm also hoping that my blood count looks good...

On Friday night, I started to feel like I was coming down with a cold. I was stuffy during the night and then started to lose my voice. By yesterday, I completely lost my voice. But, I did, thankfully, feel better than I sounded.

On a very bright note, my parents arrived on Saturday around 6pm and joined me and the kids at the "Goulash" fall festival downtown... We especially enjoyed the cemetery ghost walk put together by the Greensboro Historical Museum. Then, we went to see Doug perform at the Idiot Box. My parents finally made it to my house (after a full day of driving & activities with us) by 10pm!! It's wonderful to have them here! See some pumpkin patch pictures below...

Tingling...

On Tuesday, I talked to the PA about the tingling in my fingers and toes. We considered not taking Taxol that day and just getting Herceptin instead. However, the clinical trial recommended that if I still had functionality, I should go ahead and get the Taxol treatment. With that advise and knowing that I won't get Taxol at the next treatment on the 20th, I went ahead and took the full chemo dose on schedule. (The Taxol schedule is once a week for three weeks, then one week off. Then, repeat for 16 weeks until the end of January.)

However, I must say, the tingling in my toes got much worse... and even crept up my leg. I told Doug that if the tingling doesn't go away by the next scheduled Taxol treatment (Oct 27th), I will stop. It is a realistic fear that the tingling and numbness will be permanent. So, I don't want to do anything to make that my new "norm".

The tingling is the worst at night while I try to sleep. The strange sensation actually keeps me up. I'm sure part of it is that I'm nervous that we went too far. But, I need not think like that! It will go away... I have to believe that it will...

Thanks for all the responses from my survey last week. Despite, the fact that everyone said they would love more updates, it took longer for me to write an update. (I think I really wanted to say the tingling had stopped before writing... but, no such luck!)

Doug's mom just left today. It was a nice week long visit and she was very helpful. I just wish I hadn't been so tired while she was here. We'll miss her! (And, the kids will especially miss having hot tea in the mornings! She definitely spoiled them!)

P.S. Last weekend Aidan celebrated his 9th birthday!! (I can't believe he is already 9 years old!) We took him and two of his buddies to MagiQuest in Concord. He absolutely LOVED it. Even Regan had a great time. Check out the website...

http://www.magiquest.com

Taxol/Herceptin Treatment #2

I had blood labs, an appointment with my physician assistant and chemo today.... err, yesterday. (I guess I am officially into the next day since it is after midnight.)

All went fine. They were happy to see that I had developed quite a rash on my face since starting the Lapatinib pills last week. Why happy? Well, apparently, there have been studies showing that people who get rashes have a better result from the drug. So, although I look like a teenager with a bad complexion, I guess it is good. At least, they gave me a prescription for it. I hope it helps!

The other side affect of Lapatinib keeps me running to a bathroom... Goodness. This stuff isn't fun. But, I must say, I'd much rather have these symptoms than feeling so awful from the AC treatments I was on before. This is a "walk in the park" in comparison!

Also, I'm getting some soft hair on top of my head. Although, Taxol does cause hair loss, I'm on it weekly which means my dose is smaller... This allows some hair to regrow. Yay! (Now, how long does it take to grow hair?!?)

Since I fell asleep during treatment last time, I had Doug simply drop me off and pick me up after. There was no need for someone to join me while I napped. Although, I did ask for less Benadryl. And, even though they reduced the dose by half, I still couldn't read my book or play with my new iphone... (yes! I said iphone. I got it on Sunday and it is fabulous!)

During chemo, I had no bad reactions to the taxol, again. That was great. But, I did notice a little tingling in my toes and even less in my fingers tonight. I'll call them about that tomorrow. But, we did expect some of that to happen. As long as it doesn't stay for too long (approaching a week), I'm good.

Since I slept all day, I'm now awake. But, the sleep was good. I'm actually feeling more refreshed right now (albeit in the middle of the night) than I have most of this week. I must admit, I've been quite tired keeping up with our crazy schedules.

Now, a question to my readers... Do I update this blog enough? A friend wanted me to add a poll to find out what everyone thinks. She thinks I need more updates! Let me know what you think!

Echo, MRI and Yesterday's Chemo

I had my doctor appointment at 12pm and chemo at 1pm yesterday. Chemo lasted until after 6pm!! Wow... Thank goodness they gave me a bed instead of a chair! (They must have known it would take a while!)

The Benedryl they gave me during chemo yesterday completely put me out... I actually fell asleep. (Thank goodness Doug had his iphone and ipod to keep him occupied!) I'm sorry I didn't update everyone last night but I just couldn't keep my eyes open and slept through until this morning!

Here are the results I received from tests I took last week...

Echo: My heart looks fine... no changes. (yippee!)

MRI Results:

Lump: 1.3 x 2.0 x 1.7 cm (Before chemo it was 1.8 x 1.7 x 1.5 cm.)

DCIS: 9.0 x 7.1 x 3.6 cm (We don't expect this to melt away since it is "precancerous"... but, I was praying for it to happen to avoid a mastectomy.)

MRI Impression:

1) Mass within the upper-outer quadrant of the right breast appears essentially unchanged compared to MRI on 6/10/2009.
2) Persistent large area of enhancement involving the lower outer quadrant of the right breast. The overall dimensions of this region are essentially unchanged. The amount of enhancement within this region is subjectively less confluent than on the previous exam.

Dr. Rubin said that the lump is much smaller in size in the clinical measurement. Despite the findings on the MRI, he is very positive that the lump he can measure in the office has decreased greatly. He said it is less confluent... which means the cancer cells aren't close enough together to form as big of a mass. He is positive that the lump will be attacked by the new chemo treatments of Taxol, Herceptin and Lapatinib.

Chemo went well. I didn't have any adverse reactions to the drugs. They were prepared for a bad reaction as they should be. But, nothing was needed. I hope I don't need as much Benedryl next time or my plan of returning to work right after chemo won't work... I would be sleeping the afternoon away at my desk, for sure!

I'm back at work today... Slightly tired and a little dizzy but feeling great otherwise!! Yay! =)

Next set of drugs... Taxol, Herceptin & Tykerb

Taxol is called a mitotic inhibitor. Cells grow by a process called mitosis (cell division). Taxol targets rapidly growing cancer cells, sticks to them while they are trying to divide, and prevents them from completing the division process. Since the cancer cells cannot divide into new cells, it can't grow and metastasize.

Taxol is a clear, colorless fluid that is given as a chemotherapy infusion. Because it is quite thick and sticky, it requires a pump to properly administer the infusion.
Taxol is made from Yew trees (genus Taxus).

Possible Side effects:

Peripheral neuropathy (tingling and numbness in hands and feet due to irritation of nerves)
Neutropenia (low white blood cell count, greater risk of infection)
Bone and muscle aches
Hair loss
Fatigue
Nausea
Vomiting
Mild diarrhea
Mucositis (irritated mucous membrane in your mouth)
Changes in nails (brittle or yellowed)

Recommended: Use L-Glutamine to prevent neuropathy.

Herceptin is a protein that targets and binds to the HER2 protein (human epidermal growth factor receptor2). HER2 is found on the outer surface of 25 to 30% of breast cancer cells. Herceptin interferes with the HER2-positive tumor cells, preventing their growth, and causing them to die. It is a white to pale yellow fluid given in a chemotherapy infusion, to fight breast, prostate, colon and ovarian cancers.

How Herceptin Works:
Herceptin is part of a new class of drugs that are called targeted (biologic) therapies. This drug works by hunting down only those cancer cells that have HER2/neu receptors on their outer surface. The HER2 gene makes a protein receptor on the surface of a tumor cell. This receptor signals the cell to divide and multiply. When there is too much HER2 in breast cancer tissue, cell division goes out of control, growing much too quickly. Herceptin attaches to the HER2 receptors and blocks the growth signal, preventing more cell division, and slowing the progress of the cancer.

Some Common Side Effects
Chills or fever
Weakness
Nausea
Body pain

Tykerb is molecular inhibitor of a tyrosine kinase (a type of enzyme) called HER2. The Tykerb molecule finds a HER2 positive cancer cell, enters it, and blocks the cell's ability to respond to growth signals. When the cancer cells can't receive growth signals, they fail to divide, and disease progression is stopped.

Last AC treatment done....

I'm sitting here glad that I have recovered from my last AC treatment. But, I must admit, I'm also scared for the next set of weekly Taxol treatments in my near future. They have a new set of rules and conditions for me to learn. Starting a new phase may not be as easy as I had thought it would be. My mind pushes me into scary places... And, I just don't want to go there.

Generally, I've been living my life as "usual"... But, tonight, "it" just seems to be tugging at me for more attention. It doesn't help that I'm reading a book about someone else's path through this nightmare. I had to stop reading. Right now, my eyes are still so blurry from tears that I can barely read what I'm typing.

At the last appointment with the physicians assistant, we discussed that my clinical (pre-surgery) stage was a IIB. Of course, what does this mean? What are my chances of survival? Prognosis and survival rate can depend on a great many things. Type of cancer, treatments, lifestyle, and genetics all play a very important role in being a cancer survivor.

However, there are statistics available that sum up survival rates by breast cancer stage. The following are based on studies of a 5 year survival rate.

Stage 0: 100%
Stage I:100%
Stage IIA: 92%
Stage IIB:81%
Stage IIIA:67%

The prognosis, 81% chance that I will still be here in 5 years is pretty good, I think. But, I'm still scared. There is also that other 19%. And, this is keeping me up tonight...

I'll be better tomorrow... But, for now, I just needed to write and ask for some "extra" prayers. I appreciate all of them and know they will work! I guess I just need some reassurance... Thanks to everyone for being so supportive. I love you!

3rd Chemo was much better....

The amazing drug, Zofran, and my mom pushing to keep me hydrated helped tremendously during round three of chemo. I slept an amazing amount of hours. But, luckily, never felt as bad as I did during the first two rounds. I even had a few crackers on day 1, mashed potatoes on day 2, and macaroni/mashed potatoes on day 3. That's progress!!

While my mom has been taking care of me, my dad has been taking care of the kids. And, I believe they have worn him out!

I want to thank everyone for their prayers... and, the food we have received has been great. It is definitely one less thing to worry about while we go through this madness.

Today, I'm back at work catching up. I'm a little weak but I'm doing great. In fact, I can't wait until I can eat a real meal... and, I bet that meal just may be tonight!!!

How my kids reacted to me losing my hair...

Although, we prepared the kids for me to go bald, I wasn't quite sure how they would react when they actually saw it. On Friday, we drove up to Pittsburgh and saw the kids for the first time since I lost my hair. We arrived late and somewhat assumed that the kids would be asleep. But, since their cousins had also arrived Friday evening, the kids were all still awake and happily playing away when I came into the house with just a hat on my head.

Aidan ran up to greet us and quickly realized that I had lost my hair. After a few minutes, he pulled me to the side to make sure I knew that he would always love me. Then, I went upstairs to find Regan. She ran up to me, slowed down as she spotted the hat, and then gave me a big hug and kiss... Her cousin, Samantha, who knew nothing of my condition, quietly looked at me. I believe she was a little scared to see her Aunt Lara without hair. As I retreated back downstairs, I decided I had to tell Regan something and walked back up. Regan saw me and ran to my side to tell me that she was just explaining to Samantha why I was bald. (So, she did notice!)

The next day, I forced myself to wear the wig I bought... I had to try to get over the nausea I associated with the wig. (Unfortunately, I looked at wigs the same day of my first chemo and picked up my wig on my way to chemo #2. This association with chemo wasn't good for me. I actually had to hide my wig from view so I wouldn't feel sick!)

Everyone loved the wig.... and, my niece was much more talkative around me once I had hair. When Aidan saw me in the wig, he immediately reached up to touch my hair as he usually did with my real hair... His hand pulled away as he realized it was a wig but then went back up to touch it again. He said my hair felt different but it was ok. (I then asked him to be careful when touching my hair so he doesn't pull it off! Boy, that would be embarrassing!)

Later that night, Aidan came into my room while I was changing. I had no wig or hat on my head... I was completely bald. I asked him if he was ok. And, he told me he was... then, he reassured me that my hair would grow back... What a sweet kid!

I'm glad my kids are ok with my bald head. I know that every time I look into the mirror, I kind of scare myself. So, I'm pretty darn proud of them.

I've got another week to go before chemo #3. (Thank goodness!) I'm looking forward to enjoying a family reunion this weekend. Despite the craziness the last couple of months, I've had an amazing summer...