Delayed Radiation

   Slacking off on the updates again. But most of you probably saw me last week in Charleston so I'm obviously still alive. Our vacation was barely a vacation but I got all my errands done and I finally graduated from college (with honors thanks to my 3.875 GPA, which I'm allowed to brag about).
   I had a job interview the day after we got back, but I don't think I got the job. The guy I was supposed to see had some kind of emergency, but the other guy I talked to said my technical skills weren't where he wanted them, but that my attitude was right. Oh well, it's probably better to wait until after radiation to work anyway.
   I went to the emergency room later that day too. This incision problem has just gotten worse. The doctor there said it looked like an ulcer, but again, not infected. They gave me some antibiotics anyway. And some non-stick bandages that won't irritate it more.
   I saw the radiation oncologist Friday to take some "pictures". I got Dr. B to look at my incision first since I was supposed to start radiation yesterday (Monday). She gave me some Silvadene cream to put on it until I saw my surgeon. I have an appointment to see Dr. B again May 29th, and will probably start radiation then instead. The "pictures" that they kept talking about involved me pretending to get radiated, lying half-naked on a tiny wooden board five feet in the air with this huge scary machine shooting laser beams across my chest. The elaborate tree picture on the ceiling was a nice touch and all but the machine blocks it completely, and instead I had to stare at a reflection of my flat, scarred chest for 30 minutes. Thankfully when I actually get radiated, it won't take so long, because my arms were starting to go numb.
   I finally saw Dr. K Monday. That gross red gooey spot on my incision? Just my skin coming apart. The scar tissue is so thin and weak, it's just splitting open. Apparently the moisturizing cream I've been using wasn't enough, so she told me to go buy ointment and make sure it stays moist. All the time. She said the other side might do the same thing. Great. But I can go ahead and start radiation because there's nothing I can really do about it. The radiation might make it better or worse, so I guess we'll see.
  I'm getting the Herceptin again tomorrow. And I'll find out Thursday about starting physical therapy.

Fat Pads, Radiation Tattoos, and an Oozing Incision

Oops, I can't believe it's been a whole month since an update.
   I had another MUGA heart scan the day after my radiation appointment, and everything's okay, so I've been getting the Herceptin every three weeks as planned (only seven more months!).
   I had another radiation appointment for the planning stuff. They gave me three tiny tattoos, one on each side of my chest and one in the front on the right side. These are to make sure I'm lined up correctly everyday when I get treatment. She had to redo the tattoos three times to make sure they were visible enough (which was fine with me because I want to make sure they're radiating the right spot!). It just felt like she was digging holes in my skin. And then I bled all over my shirt.
   I go back for another prep appointment Friday, May 18th, before I start the treatments. My appointment time is 11:30 everyday and it should only take about 15 minutes each time. I'll see Dr. B once a week for bloodwork and a checkup to make sure my skin hasn't fallen off I guess. I tried to fill my prescription for the cream that's supposed to help, but the clinic pharmacy could barely read the handwriting. I saw three pharmacists in the back on their smartphones trying to figure out what "Prutect" was while we waited for 30 minutes. They thought it was over-the-counter and had no clue what it was for, even after I told them. We finally just left and one of them ended up calling me to say they had to order it and it'd be a few days (this was 2 weeks ago?). This is why I go to CVS and just pay the copay, at least they get you in and out in 15 minutes!
   I also went to visit Dr. K. Twice. Without an appointment. I noticed the left side near my armpit looks swollen, so I called and she told me to come in. She did an ultrasound to make sure there's no fluid and said it's just fat. Normally, breast tissue weighs down the fat in that area so we don't notice it, but since I'm so little, it looks more obvious. She said she can thin it out when I get my port taken out, and she'll fix up the old port scar. She'll have to do it as outpatient surgery, but I wasn't looking forward to having the port taken out in the office while awake anyway.
   I must have missed her, so I went to see her again a few weeks later. The right incision was starting to ooze near my armpit. She looked at it and said it wasn't infected, but that the bandages I was using were tearing up my skin. So she gave me some waterproof ones that I can change less often. But it's STILL oozing. Dr. C looked at it today and said it's not infected, and that an infection would be very obvious. So he stocked me up with some more bandages, and I just need to wait it out. He explained how the incision is very taunt in that area and how every time I move my arm, it's putting more pressure on it. So it's basically the incision trying to split open. He did mention that they might not start radiation on schedule if I'm still oozing. So hopefully it'll start healing properly so I can get all this crap over with. It's really hard to NOT use my right arm so with my luck this is going to take a while. I was reaching up for something earlier and suddenly felt shooting pains all down my arm. Gotta love lymph node dissections...
   I finally went to the dentist for a checkup and cleaning (unlike certain other members of my family!). I found a new dentist in Mt. Holly and they were much better than the last one. Nobody sprayed my face with water this time. I had two cavities, one of them was next to the bonding from my fake tooth. I didn't realize that could happen. But the dentist was great and smoothed down both sides for me so it'll be less likely to develop more cavities. They do the Maryland bridges too so when these pop off, I have somewhere to go to fix them.
   Besides that, I've been feeling fine. My energy level has definitely improved, even though radiation is going to make me tired again. But I'm done with classes and college! Graduation is May 12th, and it seems like EVERYONE in my family is going. But afterward, I get to relax a little and spend my summer applying/praying for jobs.

Radiation Bummer

   We saw Dr. B today. The nurse who took my vital signs asked what my real age was, because she didn't believe I was only 22. At least someone thought I was older and not younger this time, especially with this new flat chest.
   I was really hoping with the reduction in the tumor size from chemo and the clean margins and the low grade that I would be able to skip radiation. But since the cancer was still there after chemo, there could be other cells in that area. And since chemo got delayed/reduced so much because of all the side effects, even Dr. C recommends I get radiation. So Dr. B has a definite decision now, and I'm going to get 28 treatments or 5 and a half weeks.
   She said she's not going to radiate the lymph nodes in my armpit, since they were all removed, but she's going to do the whole breast area and the lymph nodes above my collarbone. Some possible side effects: skin thickening, a permanently darkened/reddened area, greater propensity to rib fractures, some minimal lung damage, and, rarely, secondary cancers. And the hair might not grow back in that area, which is the only good thing I see about all this. With the costochondritis at least, she said that the patients who develop it during treatment usually get better after treatments end, and that if it is an inflammatory issue, the radiation might actually make it better by killing off the white blood cells in that area.
   She says if I don't get radiation I might not even be around later to worry about a local recurrence. And if all of my doctors are recommending I do it, surely it's for my benefit. We're waiting until after my graduation at least, and I'll start Monday, May 21st, after we get back.
I'm really bummed out, but this is just cancer being crappy as usual.

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.

Done!

...with chemo at least.
   No Taxol #12 this week. The numbness has stayed about the same, but he kept asking if I was having pains in my fingers, as if that was going to determine whether or not I had the last treatment. Then again, for the last 6 weeks, he kept asking if I was still able to button buttons and tie shoelaces without problems (two completely avoidable tasks) as if THAT would determine whether to continue treatments. He did acknowledge the issues I've been having typing on my phone or a keyboard for the past few weeks (much more important!).
   Thankfully, he let me stop so I'm officially done with chemo! And I'm two weeks out from the last treatment, so I've been feeling much better. I even got on my exercise bike last night, since my legs were already sore (thanks to a combination of six months of not moving, some leftover Taxol side effects, and those flu-like symptoms associated with Herceptin). But after about 20 minutes, my feet went numb. So I'm really glad we didn't push those last two Taxols. Hopefully all this numbness and tingling will start to go away, along with these other crappy side effects. My skin's started cracking and peeling because it's so dry. I'm still waiting for my constantly runny/bloody nose to get better. The hair on my head's definitely grown out at least an inch, but it's mostly on the top and in the back. My forehead looks huge now because most of the hair in the front has thinned or fallen out. I still haven't shaved my armpits or my legs in weeks, which is nice and all, but my eyebrows are disappearing too, so I could use some hair growth. My chest pain mostly went away last week, but in the last few days, my shoulder starting hurting again, but this time on the left side. I've been popping ibuprofen and that seems to help.
   The nurses printed off a copy of my blood counts (since I actually remembered this time), and they're slowly going back up. My hemoglobin was 9.7 and platelets went up to 127 (almost normal). But then I noticed the "Gender" on the printout says "Male". I know I don't have as many female hormones running through my body anymore and I'm about to get my boobs cut off, but seriously? They fixed it right away, but I wonder how long it's been like that and if it's affected anything...
   I also called Dr. K's office last week to reschedule my surgery. It's now for Tuesday, March 20, and I have a pre-op appointment in two weeks for any last-minute questions. I really don't think it'll be that bad, since they aren't ripping out any lymph nodes this time, and especially in comparison to six months of chemo hell (most of which is a blur thankfully). I'm just ready to be done with all this.
   I'm still getting the Herceptin, but now it's every three weeks, so my next appointment isn't for a while. My next MUGA heart scan is scheduled for February 6th. Speaking of never-ending appointments, we had to reschedule the one for the dogs, but Zeus hasn't been chewing on his feet lately, and instead has been getting into the trash and tearing everything up to occupy himself. Guess that's a trade-off?
   And Skye's still fat.

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.