Friday, March 7, 2014

The Zone

It's done.  The first batch of hard chemotherapy drugs have now entered my system.  Operation kick cancer's a$$ (as you all have so aptly named it) has officially begun.  I am relieved to know that cancer's hall pass was officially revoked today.

And now I am in what I previously called The Zone.  The dexamethaSONE.  I had forgotten all about this particular side effect.  Dexamethasone is a steroid that they administer intravenously before giving me the hard chemo drugs.  It helps to keep the nausea at bay.  Today it has had a bonus effect of clearing my congestion.  It also makes my heart race and my cheeks flush.  This blog post would not be happening without The Zone, because I was dozing in my chair a few hours ago, but now I'm getting more and more amped by the minute.  Dance party, anyone?

This brings up something that I've been mulling over.  Should I re-read my old blog posts or shouldn't I?  I know that there are some gems in there, but perhaps some things are best left to be rediscovered.  Like childbirth.  The mind copes by forgetting the worst of the pain (labor) and remembering the best of the process (baby).  Perhaps chemotherapy is similar.  I've forgotten the worst of the pain (secondary infections? fatigue? hot flashes? etc. etc. etc.) and only remember the best parts (that I'm alive and won't have to shave my legs for five months).

Today I learned the chemotherapy plan and can at long last tell you about it.  I have 18 weeks of hard chemotherapies ahead of me.  We'll repeat what we did today again three weeks from today, and so on until we've done it 6 times (huzzah for being done with one!).  Here's what we did today:

1) Pertuzumab.  It is a brand new drug (clinical trial results published in 2013) against the Her2 and Her3 receptors.  I am the first person in my clinic to use this drug.  They ordered it special, just for me.  It took 1.5 hours to administer.  It has essentially no side effects.  Interestingly, it is unclear if my insurance will cover this drug since it has not been approved in the metastatic setting (stupid innumerable pulmonary nodules!).  However, one of the drug companies who makes it is offering pertuzumab for FREE to patients who qualify (based on income).  The clinic filed my paperwork last night, and at 8 am this morning called to tell me that I qualify!  Huzzah for all of these people who worked their tails off so that I could receive this drug today and not have to worry about potential insurance issues.  It brings me to tears.  I am grateful.

2)  Emend and Dexamethasone.  I already told you about dexamethasone.  Emend is another potent anti-nausea drug.  Together these drugs took one hour to drip into my system.  These drugs are administered after the pertuzumab because they need to be given before the hard drugs (numbers 4 and 5), but the pertuzumab and the herceptin (number 3) need to be administered an hour apart.  I've got a complicated program.

3)  Herceptin.  Herceptin is another Her2 inhibitor.  It has essentially no side effects except possibly on my heart.  With both herceptin and pertuzumab we have to keep an eye on my heart because these drugs can weaken it.  I'll just have to override that and stay strong.    

4) Taxotere.  Sigh.  This is a general mitotic inhibitor, meaning that it inhibits rapidly dividing cells like cancer cells.  It is not specific to cancer cells, however, so other cells that rapidly divide are also inhibited.  This includes hair follicles, nail beds, and bone marrow.  This drug took an hour to administer.

5)  Carboplatin.  Double sigh.  This is another general mitotic inhibitor.  I was just told today that sometimes the body remembers carboplatin and doesn't like it, so I'm supposed to be on the look-out for unusual side effects, like perhaps extra tingling in my extremities or something.  It's going to be hard to notice extra side effects on top of the side effects, but I'll try.  This drug only took 30 minutes to administer.

That's the scary part of my program, to be repeated at three week intervals for a total of 6 times.

The second aspect of my program will be Friday dosings of numbers 1 and 3 above.  This will happen every Friday throughout the scary program.

Additionally, somewhere in the middle of chemotherapy I will have to do another round of tests and scans to check on the "lung metastases".  If they are gone, we will proceed with chemotherapy as planned.  If they are still there, it's possible that we'll have to come up with a new strategy.  Chemotherapy, surgery, and radiation are all dependent on what those lung spots do.  But they're going to be gone, right everyone?  They're probably gone already.  ;)

I have one thing for which I need your help.  On Monday I have to give another blood sample for a different test (but they can now use my PICC line, huzzah!).  It will be a test to see if there are cancer cells in my blood.  We really do not want there to be cancer cells in my blood.  Could you please help me with this idea?  I've been using my mind powers to keep the cancer cells quarantined, but it seems that I could use a bit of help in this arena.  Thank you for your energy.

Thank you for the support we had today, both physically and mentally.  When we got to my appointment and were told it would be 6 hours, we realized that it will be impossible for us to do this day without some help.  Thank you so much, dad and aunt J, for spending your day with us.  Thank you, MIL, for spending your evening with us.

It is coming.  With every passing moment I feel myself getting farther and farther away.



    And love.

  2. Pro: New drug = frontier of science. I think you're comfortable in that setting at this point. Your publication count is approaching my age, after all.

    Pro: Known knowns. The drugs you know, you know. Fear is henceforth eliminated.

    Pro: Alaska airlines now flies nonstop fron Seattle to within a 150 mile radius of Burnette.

    Sleep well and see you tomorrow night.

    1. Steel Reserve, Led Zeppelin, beef jerky, Foo Fighters, wiper fluid, corn nuts; in no particular order.....

      Nephew, Uncle, windshield, Foo, snacks, and the ultimate kill cancer plan....

      (Jack Black) Take The Wheel.....Omaha to Ames in 30 minutes...#BatmanisdrivingtheKia

  3. My every thought is with you. I can hear your laugh and I can see your smile. In fact, based on everything you had pumped into you today, if I looked outside my porch to the North, I could probably see you glowing. But then, isn't that just you. Glowing. With all you had to endure today my dear, you let us all know you are doing OK. You will be OK. We are going to make sure of that...but you make it soooo easy for us.

    Your Offensive Coordinator is in route. When the eagle lands, I will bring him to your nest. I love you sweet girl. Rest easy, and shine on:) umm, yes, well...literally.

  4. Cowgirl quarantine riding in from Montana to help lassoe loose straggler cancer cells and get 'em corraled. Yee haw! Sending you lots of strong energy vibes.

  5. I'm waiting for Baby Carter to wake up to eat so that we can all go back to sleep! Makes sense, right. During this waiting time prayers, thoughts, good vibes, energy, and everything else I have are coming your way.You will prevail!!!

  6. Speechless. Bob Marley's "Three little birds" would be a good listen. Kate is watching over you HK Jetson!

  7. I love you so much. You've got this sister! This baby is going to be out just in time to help you kick this cancer to the curb. How amazing about this new drug already for your treatment and even more amazing how quickly they hooked you up (literally). Xoxoxoxo

  8. Show them what this new drug can do!!!

    Lots of love and warm fuzzies.

  9. My whole family made it their promise for Lent to keep you in their prayers daily, so hopefully that counts for positive energy you need, between now and Monday and also beyond.

    You have one of the strongest hearts of anyone I know. Cancer round one couldn't get you down, cancer round two will I am sure be no more successful. Much love H-bomb!

    1. Frank - I love that your whole family is giving up Heather's cancer for Lent . . . and forever! Bless every one of you.