Cellular torture

My daughters have a small indoor tent made out of a material that is a strange hybrid of fabric and paper.  Dora the Explorer images are printed on each of the four sides.  They've had it for several years, set up in the toy room by the window as a special reading nook.  On Labor Day weekend I wasn't feeling tip top, but despite my lack of energy I wanted to do small things to make the weekend special.  One thing I thought to do was take the Dora tent outside.  Not to be bothered by collapsing the thing, I picked up the tent by the peak, which unfortunately elicited a ripping sound.  I awkwardly maneuvered the torn tent down the stairs, at which point Azalea pointed out a large tear down the back of the tent, reaching up to the ridgeline from the back door.  I reached for some masking tape, intending to fix the tent just enough to perform this final outdoor activity before depositing it in the trash.  With tape in hand I pinched the new seam, which readily flaked off a chunk of the paper-like fabric between my fingers.  I chose a different ripped location and grabbed again, liberating another hunk of the tent into my palm.  The fabric must have weakened over time, perhaps because of sun exposure at the window.  Before my small ones could throw a fit over their disintegrating play house, I embraced the tent, tear and all, and tossed it into the yard.

My brain on taxotere is the fabric of the Dora tent.  Weak, fragmented, and orange.  Each morning I toss myself into life and hope for the best.  

Fortunately I am feeling a little better every day, and I will continue to get better in the absence of further cellular torture by chemotherapy.  At night I send my healing thoughts to my brain, taping up the pieces of my mind.  This week I have caught myself making some coherent thoughts, so I thought I'd attempt this blog post.

Tomorrow we make the drive to the other town for my pre-mastectomy procedures.  At 2pm I am having vascular pictures taken.  These are for the doctor who is going to be placing my port.  I used to have a port, but I had it removed after being cancer-free for almost 3 years.  Dr. Oncologist chose not to re-install my port for the current cancer treatment for numerous reasons.  However, now that I am looking to be infused with Herceptin and Pertuzumab every three weeks for the rest of my life, I asked if I could get another port.  I figured I could get it installed at the same time as my mastectomy.  All of doctors on my team thought that this was an excellent idea.  My port will be placed in exactly the same location as my old one:  chest wall, center-right side, just below the collarbone.  A doctor whom I have not met yet will come into the operating room after my mastectomy and hook me up.

At 3pm tomorrow I will be injected with a radioactive tracer.  This will be injected into the breast cancer.  On Wednesday the doctors will be able to follow the trail of radioactivity to see which lymph nodes to remove.  This procedure is called sentinel lymph node dissection.  I didn't have this before because it is not recommended in cases of inflammatory breast cancer.  It is recommended for ductal carcinoma in situ, which is my current diagnosis.

My surgery is scheduled for 7 am on Wednesday.  I am to report to the hospital at 6am.  My husband, parents, sister, and mascot (Calvin the Cure) will be there.  I will stay in the hospital for a night or two.

On my previous mastectomy eve, my college friends booked a room for Ian and I at a fancy, contemporary hotel.  I decided to do the same this time, for luck or something like it.  I'm not superstitious.  It just seems like an appropriate night to be a tiny bit spoiled.

I am grateful to not have any downtime between my last chemotherapy and this surgery.  It's true that the surgery will keep my healing energies busy, and that my healing energies could use a break.  However, I feel that it will be easier to maintain my healing routine than to be teased by a break from healing only to be plunged back into the fray at a later date.  Besides, I don't want the cancer to think that I've gotten complacent.  Kick it to the curb!

48 hours from now my cancer will find itself excised from its happy Heather bath.  It will be slapped onto a lab technician's benchtop, fixed in formalin, set in paraffin wax, and sliced into thin preparations for a pathologist to scrutinize under a hot, microscopic spotlight.  I am not a vindictive person, but after all of the pain that cancer has caused me, I delight in the cellular torture that is about to be inflicted on it.    

User's guide to taxotere

Here is a breakdown of my week with taxotere and the counter-side-effect drugs (e.g. steroids) as the only aggressors to my system.

Day 1 (infusion day):  My PICC line was removed about a week before the taxotere infusion, so the taxotere had to be infused via a vein in my hand.  That evening, my hand felt like there were tiny fireworks occasionally going off under the skin, always in different places.  I knitted for several hours that night to encourage whatever was causing the fireworks to flow with the blood out of my hand.  Next time I think I will ice my hand during the taxotere infusion, which will temporarily decrease the flow of blood to the hand and perhaps decrease the taxotere fireworks.  Also, the steroids kept me awake until 4 am, so knitting away fireworks was an excellent activity.

Day 2:  I felt deceptively awesome, and that's about all that I remember about Day 2.  I drank a lot of water to flush the drugs out of my system.  I kept eating, walking, and Doing Stuff, and my husband kept commenting on how awesome I was doing.  I walked to the clinic to get my Neulasta shot, then I napped all afternoon, then I helped with supper.  My probiotic regimen (serving of yogurt for breakfast or lunch, probiotic pill after dinner) started on this day.

Day 3:  I reached my functional peak when I awoke and made blueberry pancakes.  The crumminess started to set in after that.  My bones started to feel sore and oh so heavy.  My brain started to feel foggy.  Both ends of my guts were holding steady, no nausea or diarrhea, but these two things usually kick in on Taxotere Day 5.  Napping and resting became functional requirements on this day.

Day 4:  The slide down to the taxotere valley was in full swing.  Heaviness and fogginess, but I still ate food, went on a 2-block walk, and took a nap.  This day marked the beginning of the unsteadiness taxotere always brings.  It's not the same as dizziness or lightheadedness.  I call it "spinny".  The only cure for spinny-ness is time, although laying down helps prevent the spinny-ness from aggravating the nausea.  

Day 5 (Tuesday):  The taxotere valley.  Spinny, foggy, heavy, sore.  This day was marked by the crumminess reaching a depth from which complaints failed to emerge.  I've noticed this about myself--I can tell when I'm starting to feel better because I start to complain more about my woes to whomever is around.  When I'm feeling my worst I tend to complain less, making my feelings clear by closing my eyes and sleeping through it all.  The good news about this taxotere valley is that the nausea and diarrhea did not start up.  Perhaps my probiotic regimen is working?

Day 6:  The valley continued onto this day.  Also on this day, my taste buds started to get weird.  This is an inconvenience, but does not prevent me from eating.  Foods simply don't taste the way I think they should; this will persist for another week, then be better until my next treatment.    

Day 7:  The fog started to lift from the valley.  My mom could tell that I felt better just by looking at me.  All that ailed me was simply less.  Also, my secret weapon for Day 7 is a little being named Calvin.  Calvin is my newest nephew, and he was born three days after I started chemotherapy (March 7).  My sister has brought him up to hang out with me every Thursday after treatment.  He is a marvelous baby, never fussy, and a is glorious antidote to my ailments.  He and I lay around and chat for hours, then when it's time for my walk I push him in the stroller, which serves as a walker for me.  It's the best.

Calvin the Cure.  No pressure. 

This has nothing to do with this post, but he came to my chemo appointment last Friday and made everything better.  He's the best. 

Day 8 (today):  I think it's fair to say that I am already monumentally better.  At my appointment today, Dr. O said that my blood is good--I'm neither anemic or neutropenic.  I feel heavy, only a bit nauseous, and blah blah blah who cares because it is so good to feel decent!

Now I am entering the time when it's hard to strike the right balance between what I want to do and what I should do, because I still have a lot of resting and recovering to do.  Those three doses of FEC were crazy disruptive, giving me barely one good week out of every three.  Now it's looking like I'm going to get two solid good weeks out of every three.  Paradise!  Oh, and for all of you in-laws in the audience, Dr. O gave me permission to attend the family reunion next weekend--I can't wait to disseminate hugs!     

My last bit of good news is that today Dr. O told me that she won't have me get another PICC line installed.  Huzzah!  My former PICC line site is healing quite nicely but the skin is still swollen and discolored, perhaps from scar tissue.  I guess that my hand veins performed well enough last week that she thinks I can handle the remaining two (2!) doses of taxotere without a PICC line.  This is good news to me because although the PICC line was a wonderful tool to avoid getting pokes, it was inconvenient for Life and painful for my skin.      

And now I'm going to try my hand at some Science for an hour or two.  I hardly recognize myself from where I was a month ago.  This is wonderful.