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.