Flat-Chested

   It's almost been two weeks since my surgery, and I'm feeling a lot better. I haven't needed any painkillers the past few days (even for the chest pain!). The surgery went well and I got out of the hospital Wednesday afternoon. There was some strange swelling on the left side, so I saw the doctor Friday to get it checked out, but they said it was just the tubing inside from the drain (gross). I saw the doctor again Wednesday to get the two drains taken out. Everything's kind of numb in my chest area, and I didn't have those terrible shooting pains from the lymph node surgery this time, so the drains were much easier to manage, but I was still glad to have them out. I ditched the uncomfortable hospital/surgical bra as soon as I could and I've been wearing the As Seen On TV Genie Bra because they had an extra-small that actually fits. It's almost just as hard to find bras now. I'm somewhere between the little girls and the juniors, but most of them come built-in pockets with padding. Our society's obsession with big boobs and oversexualization of pre-teens are working in my favor. Walmart even has $5 "water pads" next to the Buty Pant butt-enhancing panties. While I opted to skip the padded underwear, those cheap bra pads are good enough to make me look a little less like a flat-chested twelve year old.
   I saw Dr. K today for a follow-up. She ripped the steri-strips off both sides, but thankfully I couldn't really feel it. That swelling never really went away, so she just sucked it out with a syringe. Again, happily still numb! It's definitely flatter now, but I forgot to ask about the other swollen part at the top. Hopefully that's not just leftover skin... Everything else looks really good, completely flat and the incisions are very thin, even though each one goes from the middle of my chest up into my armpit. I think she did a great job.
   She gave me a copy of the pathology report, and said everything was fine with the surgery. The chemo obviously worked because the tumor went down from 2 cm to 0.6 cm. When I got home and looked over the report, I realized I don't know what any of it means, but Wikipedia's super helpful. Overall, I had a grade of 1 which is the lowest (and best). Tubular differentiation had a score of 3, which isn't good, but nuclear pleomorphism was only 1 and mitotic count was only 1. Nothing was found on the left side, except that fibroadenoma. While Kyle jokingly said it was a waste of a good boob, I feel better knowing I have almost no breast tissue left to form new cancer cells. Plus, they're a pair anyway; I'd rather be flat-chested on both sides than lopsided.
   Dr. K also went over some massages for my arm when I asked for a new referral for a lymphedema physical therapist. I mentioned the arm pain to the oncologist a few months ago, and they said it was lymphedema, which is why I thought it was a lymphedema... And my right hand is noticeably swollen compared to my left. She said lymphedema doesn't hurt though, it's just the swelling. She thinks it's just the muscles in my arm and I must've overused or underused that arm after the first surgery. She said to keep it elevated above my heart whenever I have a chance, and showed me the massages for both the lymphedema and for my muscle aches. If I'm still having issues in two weeks and want to see a physical therapist, she said to call. Otherwise, I'll see her in six weeks to make sure everything's doing okay. She also asked when I wanted to get the port out, but considering this is my THIRD one now, I'm going to hold onto it for as long as possible. Once I'm done with treatments with the oncologist, it'll need to be flushed every three months to keep it functional. She said they could take it right out in their office instead of dealing with all the hospital stuff. Very different from the last two ports...
   I have an appointment with Dr. B from radiation oncology tomorrow for another consultation. My chest pain finally went away (after seven weeks), but I really don't want to get radiation if it's going to aggravate it in the future. I guess we'll see what she says tomorrow.
   As for the official weight for my boobs: the right one was 439 grams and the left was 427 grams. Less than a pound each! I was expecting heavier.

Skipped Herceptin

   Now that I only have regular appointments every three weeks, I'm probably going to be lazy and update a lot less. I had a MUGA scan last week, but Dr. C called the next day to tell me the number was lower than he wanted, so I didn't get the Herceptin today. It was only 52, and my first two were 65 and 55. He said it's still normal, but I'm at a certain threshold where they want to wait and see if it gets better before giving me any more Herceptin. I have another MUGA scan scheduled for April 4th and see the doctor again April 11th.  I asked for a copy of my counts as I was leaving and apparently they still had me in the system as male. My hemoglobin was 8.7, my platelets went down to 112, but my white counts are good. Hopefully that won't mess up my surgery date next Tuesday. I'm also supposed to start the Tamoxifen when I get home from the hospital. The hot flashes stopped a few weeks ago thankfully, but this medication will probably start them up again. And I'm supposed to be on it for the next five years. Oh what fun. Besides the typical menopausal symptoms, it also has rare side effects of blood clots and uterine cancer (just can't win).

   My chest still hurts (four weeks now?). He said it's a good thing that it hurts when I push on my ribs because it sounds like a cartilage issue and not something to order a bone scan for. He even said it sounded like costochondritis, which I thought I had told him before? But either way, at least he's familiar with it. I realized I've been dealing with this on and off for almost seven years now. The only thing I can do for it is pop ibuprofen and slap a heating pad on my chest. I just hope it gets better before surgery next week.

   I saw Dr. K for a pre-op appointment last Thursday for the list of questions I've been making. She said the surgery might make my chest pain worse because it'll feel tight, but that it's fine to keep taking the ibuprofen, as long as I don't drink anything the night before surgery. And yes that crazy thing in my chest IS a power port, that's all they use apparently. I was supposed to get a booklet and a card when I was in the hospital, but she's going to try to get me another one. I should only be in the hospital for one night and the surgery should take less than three hours. I asked her not to leave any extra skin, and she said it'll be completely flat with the scars slanted with the way the muscles underneath naturally stretch. I'll have drains again, but I won't have that terrible nerve pain since they're not messing with any more lymph nodes. She said I could drive once the drains are out and I'm not drugged up on painkillers. 

   I tried to make an appointment with the radiation oncologist, but they told me to call back after my surgery. Dr. K said they can start radiation two to four weeks after surgery, but that seems too soon and I don't see how my skin would have time to heal before then? We're going to SC for a week in May so they're going to have to work around that anyway. I'm more concerned about what the heck radiation is going to do to my chest in the long run, especially with this ongoing chest pain and my swollen arm. The radiation oncologist was unsure at first whether to do it or not (September and October entries). Maybe whatever they find during surgery will influence it. Either way I'm screwed.

Skipped Taxol #11

    Treatments 7-10 of Taxol were pretty boring, just the usual tiredness and some numbness in my fingers. But last week sucked. I started to get some chest pains Saturday. No worries because it only hurt if I breathed or moved, not that I need to do those things on a regular basis. I popped some Tylenol and ibuprofen which is what the doctor told me to do when I had chest pain from the Neulasta shots. It helped a little, but it got a lot worse the next day, so I started taking Vicodin leftover from my surgery. Apparently Vicodin and Benadryl are two drugs that no longer help me sleep.
    I called the doctor Monday, since it had only gotten worse and the Vicodin was just making me feel sick. They ordered some kind of CT scan on my chest for later that day. When we got there, the nurses asked if there were any chance I could be pregnant. Doesn't anyone watch "I Didn't Know I was Pregnant"? Even though I had a whole list of evidence of why I SHOULDN'T be pregnant, they got really worried when I said I couldn't remember the date of my last period (thanks chemo!), so worried in fact that they almost wouldn't let me do the chest scan. Really? They were more concerned about a nonexistent fetus with a chemo-induced tail than the fact that I was having severe chest pains and needed a scan to make sure I didn't have a life-threatening problem with my lungs that would have killed the fetus anyway? Good to know the medical community's priorities when it comes to women of childbearing age.
    When I FINALLY convinced them that NO I'm not pregnant, they gave me an IV to insert the dye for the scan. I asked if they could use my port, but they said it had to be a "Power Port" and I had to have a card identifying it. Funny because when I asked about the three little alien bumps coming out of my skin above the port, they said it was like that so other facilities could use it too (easily identifiable). I'll ask the doctor about it next week. Instead, the nurses had to do an IV in my arm, and she so kindly told me, since the dye goes in really fast, they have to use a larger needle. Sweet. But even better when was they put the dye in later, and they warned me that it'll make me feel really warm and like I've peed my pants. "Warm" was an understatement, but it was a really strange feeling. Luckily, the scan itself only took a few minutes. They sent the results to Dr. C and sent me back out to the waiting room. Then they came back out to tell us to go home, everything was normal on the scan. Ok, but my chest still hurt?
    So I toughed it out that night and the next morning. Then I had a really bad wave of nausea and dizziness and heat hit me on the way to the hospital for my appointment. That combined with the severe pain in my chest and not being able to breathe was super fun. Thankfully the doctor has some sense and wasn't going to try to give me chemo that day, but I think it was more due to the numbness in my fingers than the chest pain. But I would've flipped out if he had tried. I think my body has maxed out on chemo at this point. He has no idea what's going on with my chest pain, because everything seemed normal. I think the chest pain's just the same thing I've had multiple times before (costochondritis) and the stress of six months of chemo made it worse. I asked the doctor if it is the same problem as before, won't radiation make it worse? He said it's just a "necessary evil" and that I'll basically just have to deal with it. Then again, he's not in charge of radiation, so I'll discuss it with the radiation oncologist before they start zapping me. For now, he told me to take some ibuprofen and see if that helps. It's definitely helping more than the Vicodin did.
    Besides the crappy week from the chest pain, my fingers and toes have just gotten worse. I noticed within the last week that when I start walking sometimes, both my feet will hurt and tingle a little. And when I dried my hands on a towel, I noticed my palms really tickled, but not in a good way. My fingertips feel really dry and puffy and it's way more noticeable all the time now instead of just when I use them. So I might be done with chemo. We'll see next week if the numbness is any better and if I can get the last treatment. I asked if the chemo'll be any less effective by stopping early, but since I've had 10 out of 12 treatments, Dr. C says it should be fine at this point. Plus, I'm kind of sick of chemo. I just got the Herceptin yesterday. We were out of there within 45 minutes of seeing the doctor. Good thing, because having an appointment after 9 means they run out of seats. Even though the Herceptin alone should be nothing compared to chemo, my lower legs and the top of my feet really hurt last night, so I guess muscle aches are still a problem.
    I also told the doctor I think I'm having hot flashes, and he said it's likely the chemo's put me in menopause and my ovaries have stopped functioning (even though my mother didn't believe that we both could be having hot flashes). That would explain the missing period. I noticed a few weeks ago I'd randomly get really hot at night, but I thought it was just because our second-floor bedroom is a furnace. But then it started happening in the middle of the day too. For someone who's usually cold ALL THE TIME, random waves of heat are kind of alarming, and then afterward, I'm even colder.
    On my To Do list: I'll need to have another MUGA scan to make sure the Herceptin isn't ruining my heart, call Dr. K to reschedule my surgery to an earlier date, call Tricare to fix their stuff as usual, pass the first round of tests coming up in my freshman-level classes, and buy some 100% cotton sheets.

Starting the Cytoxan (Again)

   Finally got some chemo yesterday, the second round of Cytoxan, but the first time with just it alone. I got there at 8:00 (Dr. C caught me in the elevator on his way up from the cafeteria), and didn't leave until 12:45. They even checked my blood counts before the other patients because they were worried I'd need a transfusion (and be there even longer...). My counts were decent though, my hemoglobin went up to 9, but my platelets were only 78. My blood pressure's still low (86/50), which means I get it taken twice by two different nurses every time.
   Getting the chemo itself was uneventful. I even managed to get some homework done. I started getting a slight headache near the end, which they had mentioned could happen if they infuse it too fast, but it went away pretty quickly. As soon as I left the hospital (and was mopping up the blood oozing out of their tiny bandaids, remind me to bring my own next time), I started feeling really nauseous and tired. I made it home and took a nap. Hopefully yesterday was the worst of it? I couldn't sleep at all last night either, and the FIVE times I got up to pee, I was really dizzy, which I'll let the nurses know today when I go for my shot. But I'm feeling better today, I just hope it doesn't get worse later in the week like with the Adriamycin.
   If there's anything else I'm supposed to update about, I definitely can't remember right now, thanks chemobrain!

First Chemo Session

   We hit up the oncologist this morning for my first round of chemo. They hooked up my port and Kyle kept calling me a cyborg. The nurse pointed out that this one is a newer model and has the three raised spots so it's easy to find. It's right under the incision, but she was able to go around it. We chatted with Dr. C first. He said the bone scan was fine. I got a prescription for a wig, just to have one if I want it later. Arienne came up to visit last week and we went hat shopping, so I have a nice selection right now.
   They took us to the chemo room and we waited around, reading Calvin & Hobbes comics on the awesome Nook Simple Touch ereader Kyle bought for me (already on Harry Potter book four!). They finally hooked me up to some anti-nausea medications and steroids. Then a flush, and then a second round of anti-nausea medications and another flush. A nurse brought out the A part of the A/C, Adriamycin, in 3 bright red syringes. She sat there and injected them slowly through my port. Another flush, and then she brought out the Cytoxan, which looked like normal saline.  I got up to use the bathroom in the middle of this and my pee had a nice bright pink tinge from the Adriamycin. The Cytoxan took over an hour to administer, but didn't give me a headache, otherwise they'd have to spread it out over a longer period of time. Kyle and I kept busy chatting with the nurses getting my prescriptions organized and with the talkative woman next to us, whose hair was starting to come back in. She's on the same schedule as me so I'll see her again. On the other side, an older woman's IV popped out and she started gushing blood everywhere. Lovely.
   Before that fiasco, the nurse was showing Kyle how to give me the Neupogen shots once a day for the next 10 days. It took many phone calls to make sure the pharmacy had them and all the information since they're a "high dollar drug," and I'm going to pick them up tomorrow. If the bone pain gets too bad, I'll stop them altogether and see how that goes. Otherwise, I'm hoping it'll be okay and I can switch to the single injection that releases the medicine over 10 days instead of running from Kyle trying to stab me every night (Hey, Mommy managed to give them just fine the last time, even after a couple of beers...).
   The nurse finally undid my machinery and trimmed some of the twine-like stitches popping out and irritating me. Dr. C stopped by to check on people, saw the nurse snipping away at my chest, and took off. Apparently blood and needles creep him out, and he's an oncologist...
   They let us leave after that (four hours later). I felt fine, except maybe a little nauseous from watching that poor woman bleed all over the floor, and heavy because they pumped so much crap in me. I came home and had to make some angry phone calls because the receptionist said I was out of visits for referrals, when I've only been 3 times and I had 6 allowed visits. I called the McGuire clinic, who told me the doctor has to call that in to Tricare. So I called the doctor's office who said they don't do that. She ended up putting it in and told me it'd probably be denied. So I called Tricare and told them I didn't really know what the heck I needed. As long as I still have visits (which I know I do), it should be fine, and since the doctor called it in, it should be approved. Tricare said doctors' offices just don't feel like doing it sometimes, but that it shouldn't be denied. It may be a pain in the ass to navigate Tricare, but I will admit once you get past that, they are awesome. I think I've paid $13 total for prescriptions just because I went to CVS instead of on base. So far, they've covered over $80,000 worth of treatment, and that was before chemo started. They did, however, deny the genetics counselor's request to test me for the P53 gene, but she's going to try to get Dr. C to order it instead.
   I called up the school's financial aid department after that to make sure my scholarships are going to go through. Some idiot part-time student-worker basically laughed as he read off all my scholarships that I would lose if I'm not a full-time student, even if I applied for a reduced courseload. He finally transferred me to someone more important, but she wasn't very nice either. She said what he said was true, UNLESS I was approved through Disability Services and she received notification. Well duh, that's what I've been doing... I called back Disability Services and they hadn't sent my paperwork out yet, which explains everything. So I will check again tomorrow to make sure it's all in order. And it better be, because I don't have a spare $4,000 sitting around.
   When I finally finished yelling at people over the phone, Kyle and I took a much needed nap on our comfy couch. I popped ANOTHER anti-nausea medication, Compazine, before our nap because I was definitely feeling bleh, and still am (even after THREE anti-nausea meds?). I did eat, and refilled my water bottle hoping to make the water taste better. Turns out it wasn't the chemo acting up, but just some really nasty hospital water. I'm still kind of nausea and drowsy, and my stomach hurts, but then I realized I recognized a familiar pain: menstrual cramps! Yea, it's about that time... That's all I need right now.

First Surgery Today

Surgery was scheduled for 10 AM this morning, so Mommy and I got to spend 3 hours waiting in an ice box. Dr. K put a fancy new port in on my left side, with a new scar since the old one's been cut open too many times already. I requested she sew it on extra tight so it doesn't come loose like the last one. No problems so far, it's only a little sore.
She also did the biopsy on the mysterious lump the MRI found in the left breast and got the results right away. If it had been cancerous, she would've done a sentinel biospy on that side too. Luckily it wasn't!
The right side wasn't so lucky apparently and Dr. K ended up taking out more than the sentinel node. I now have a really gross/bloody drain coming out of that side and a very painful armpit. A nurse just emptied it and measured 20 mL. She said it's better that the stuff comes out, otherwise it could cause an infection. I'm also on antibiotics just in case (and Vicodin mmm).
The doctor's going to talk to me in the morning to go over everything she did and what I need to do now. I have an appointment to discuss chemo this Friday, but I also have a dentist appointment next week which I need to get done before they screw over my immune system (I actually go to the dentist unlike some members of my family...). So I don't know when chemo starts yet, but will keep posted.
Now I get to spend the night in the hospital next to Miss Virginia and her pee pads. Oh and my own pee is blue for the next 24 to 48 hours.