Ch. 7 - Preparing for Treatment

Ch. 7 - Preparing for Treatment

Date of entry: Tuesday, September 25, 2007

Recovery continues to go well. Thank you to you all for all of your continued support. I appreciate everything and will continue to need your thoughts and prayers. The past few weeks have gone really well. I returned to work on September 18, 2007. It felt good to be back at work, but a little weird too. It was like I had been gone forever. On the second day I returned, the Rehabilitation Department gave me a surprise breakfast. It was so nice to have all of my immediate co-workers around me and giving me such good food and warm wishes. I also had some patients that were still in the hospital from before my surgery. They were also glad to have me back as well. It was strange receiving encouragement and support from the very people that are normally on the receiving end. Although strange, it made me feel very special. It reminded me to always go above and beyond to make people feel special each and every day. We never know what burdens someone may be carrying around.

At this point it would seem that returning to work would be one of my biggest challenges, but it has been really easy. I have occasional discomfort in my right axilla, but it does not bother me all the time. My strength is good, but I do tire a little more easily than I am accustomed. The tough part has been keeping up with work on top of my busy physician schedule and cancer related activities. I returned to work on a Tuesday. Every day that went by I reminded my husband, Clayton, of my upcoming appointments. Friday was a big day for me. I had my first appointment scheduled with the radiation oncologist, Dr. Ana Grace. When Friday finally arrived, Clayton and I had it all worked out, i.e. when and where to meet to walk into the physician's office together (her office is located at the hospital that I work). Clayton was on his way and I decided to go ahead to her office in order to meet him there. Upon arriving, I did notice that the office was a little quiet, but there were two ladies sitting in the office. I asked them for the sign in sheet. In return they asked me if I had an appointment, etc..... Long story short, I had written the appointment date down on the wrong day in my day planner. My appointment was yesterday, and I had MISSED IT! I was in shock. Inside I am thinking, how could I have done this to myself!?! I was so very disappointed. Without even thinking, tears started to roll down my face. I was speechless. I explained to them how important this visit was to me. Of course they tried to get me to relax and realize that it was not the end of the world, but for some reason, it sure felt like it!! After continuing to have tears roll, they gave me a new appointment for Monday. I would see her at 11:00 am. I attempted to compose myself and told them thank you. I then proceeded to call Clayton on his cell phone to let him know not to walk into the office. When he did not answer and I got his voice message, I really began to cry. I told him in the message what had happened and that I did not know why I was so upset, but I was really upset. I hung up, and he called me right back, he was in front of the hospital. I did not even talk to him through the phone because he was close now and I just hung up and sobbed in his arms. He calmed me down after a little while, and now... I can laugh about it. Thank goodness!!! It is really crazy how much my emotions have been all over the place at times during this challenge with cancer.

On Monday, September 24, 2007, I had two doctor appointments. At 9:00 am I saw Dr. Zhang, the oncologist who will be determining my chemotherapy course. He gave us good news. I will only have to have chemotherapy for 3 months instead of the anticipated 6 months. I will have four cycles, one treatment every 3 weeks. The drug combination he will use is Taxotere & Cytoxan. All the normal chemo drug side effects apply, but he reminded me that everyone reacts differently. With Taxotere the common side effects include neutropenia, leudopenia, anemia, hair loss, fluid retention, mouth sores, weakness, and nerve pain or unusual burning or tingling sensations. Other common side effects of taxotere include low platelets in the blood, diarrhea, nail changes, muscle pain, vomiting, and joint pain. The common side effects associated with Cytoxan include hair loss, vomiting, diarrhea, mouth sores, sterility, and jaundice. For the nausea he provided me with 2 prescriptions for anti-nausea medicine including Decadron & Zofran. Both of which I have already had filled. He stated that chemo could start at any time, just to let him know when I am ready. The only reason for the delay is that I have an appointment with my OBGYN regarding harvesting of my eggs and other fertility issues on Thursday, September 27, 2007. Dr. Zhang also mentioned that I may need a port-a-cath so that I do have not to be poked so many times during the chemo process. This sounds good to me. I just have to follow-up with the infusion nurse sometime later in the week. Also during this visit, he explained that after the 3 months of chemo, I would follow with 6 weeks of radiation, and THEN 5 years of hormonal therapy. The hormonal therapy will be in pill form and the name of the drug is Tamozifen. This was the first I had heard of this being in my treatment course, but whatever it takes is fine with me.

After leaving Dr. Zhang's office, Clayton and I headed to see Dr. Ana Grace for the radiation visit. She explained radiation in general and stated that my radiation would be for 6 weeks to the right breast only. She will be treating the entire breast with the radiation. The treatment will be daily (Monday - Friday) for 33 visits, totaling 6 weeks. When I arrive for my first visit and they do the alignment for the radiation machine, they will tattoo me to ensure proper alignment each and every time. The tattoos will be 3 small (freckle sized) blue dots. I though this would be kind of cute, like a conversation piece later in life, although only Clayton will be seeing them, it put a smile on my face. I had no idea that radiation oncologist were also tattoo artist.!?! She stated that after about 3 weeks, my skin would begin to appear like a sunburn. When this happens, she has a cream that she prescribes to aid in healing and reducing discomfort. She also stated that during radiation I cannot wear deodorant under the right arm. And overall during this time she recommended for me to purchase a metal-free deodorant from Trader Joe's (I have not purchased this yet). Each treatment should only take about 20 minutes. She gave me a booklet covering all the aspects of radiation in general and encouraged me to read in before radiation begins. She gave me an appointment for December and stated that the radiation should begin sometime at the first of the year, after completion of the chemotherapy.

All in all, I think that is everything that I know up until this point. I have two more appointments ahead of me this week, one with my OBGYN regarding fertility issues and the other is with Josephine to set up the date to have the port-a-cath inserted, if she feels this is necessary (I hope I get to have one, it should make life much easier during chemo).

Date of entry: Wednesday, September 26, 2007

This morning I went to see Josephine in the infusion center to check my veins. She said that my veins are small and would recommend a port-a-cath to be inserted. With that information, I went to Dr. Zhang's office to let him know what she said. He will therefore order for the port-a-cath insertion. This will be done by Dr. Shirazi, my surgeon. Her office will call me to set up an appointment to see her in her office and then she will schedule the out-patient surgical procedure after the visit, upon insurance verification and approval. I also did some research regarding fertility issues and feel more prepared for my visit with Dr. Spencer-Smith tomorrow.