Four Weeks after Cycle Four of Chemo

I’m still waiting to feel “normal” again. Even though it’s been 4 weeks since my last chemotherapy infusion of Epirubicin, I’m still not feeling as good as I’d like. I guess I have high expectations but I need to slow down and realize that it takes awhile to get these drugs out of the system and for the body to rebound. I’ve recently had a CT scan and a MUGA scan to see how effective the chemo was. I had an appointment with my oncologist to go over the reports and discuss the next step.

 

Turns out the CT scan results aren’t conclusive enough for us to know if the tumour in my liver has been affected or not. It doesn’t look like it’s shrunk very much, but that doesn’t necessarily mean the chemo didn’t work. The spot they’re seeing could consist of scar tissue, or it could be a mix of tumour and scar tissue….and I guess it could be a completely active tumour. The only way to determine the status of the liver tumour is through a PET scan. For those of you who aren’t from the province of Saskatchewan you may be shocked to hear that I have to go out of province to have a PET scan. Yes, you read that right. We do NOT have a PET scanner in our province and if someone needs this diagnostic test they have to go to Calgary or Edmonton (in Alberta), maybe even Winnipeg (in Manitoba). The closest destination is Edmonton which is a five hour drive. I have no idea how long it takes to get in for a PET scan out of province but I guess I’ll be finding out and can report on that J. I have no idea on what happens during a PET scan so I’m curious and excited (which may sound weird) because I know this scan will give me some definitive answers about what’s going on inside my body. No matter where I have to go for this test I’ll be driving as it’s just too expensive to fly.  

 

We did get some definitive answers from the tests though. The lymph nodes in my abdomen have shrunk considerably, and the countless bone metastases are stable. For some reason there was no mention in the report about some other fairly large tumours, including two that were in the lining around the liver. I’ve asked for some answers on that!  

 

The MUGA scan results came back and I’m extremely relieved that no damage has been done to my heart. I was worried because I had a lot of experiences with rapid heart rate and difficulty breathing during chemo. After four cycles of Epirubicin my heart is functioning the same as it was before I started chemo. This is excellent news.

 

So, here I sit in a holding pattern. Again. Once the results of the PET scan are in, we can make a decision about treatment. Some of the things we’ve discussed are Radio Frequency Ablation (RFA), or surgery to completely remove the tumour. It all depends on if it is still “functioning/alive”. I hope to get a call soon to go for that PET scan…I’m already feeling anxious about how long it may take to get in.

 

In the meantime I’ve started back on Herceptin and will start taking an Aromatase Inhibitor. This group of drugs works in a different way than Tamoxifen (which I was on last year) but it still has something to do with the estrogen receptors of the cancer. Because I’ve been off Herceptin for about 4 months I had to have a “loading dose” which took 1.5 hrs instead of the usual 30 minutes.  Of course I thought it was a total waste of time because I didn’t think I’d be affected by it. Boy was I WRONG. Everything went fine during the infusion but when I came home at 4:30 in the afternoon my back was really sore so I laid down in bed to rest. I fell asleep and woke a few times to find that I was freezing cold even though I was still fully dressed and under the covers.   Eventually I woke up at 8pm and forced myself to get out of bed and find the thermometer to take my temperature. Even though I felt cold, my temperature was above normal so I knew I was reacting to the loading dose of Herceptin. One hour later I had a fever of 38.3 but I was still cold and achy all over. I sat on the couch wrapped up in my electric blanket trying to warm up. I had that sucker turned up to high and it still didn’t seem to be warm enough for me.  I took some extra strength Tylenol at 8 and my temperature cooled back to down to 37.7 (still high) and gradually decreased overnight. I was out of bed for less than an hour but I managed to have some cereal for supper (!!!)  before crawling right back in with a good book where I lay sweating until after 2am.  I realized that night I’d much rather be lying there hot than freezing cold. I felt so cold that I was tense, curled up into a ball, and practically had chattering teeth. At least when you FEEL the heat of the fever you can just lay there with the covers off trying to cool down.

 

Of course I felt the effects the next day as well. I slept til at least noon and had a headache off and on all day…once again I started taking Tylenol.  I even had a bit of a headache the day after that…mostly when I’d bend over or exert myself in some way. Thankfully by day 3 I felt normal again – well, as normal as I can feel right now! The really weird thing in all of this is that I had pretty much the exact same reaction the FIRST time I had a Herceptin loading dose – 10 years ago. Wacky.

 

I can tell that I am on the road to recovery from the four cycles of Epirubicin with tiny little things that I’ve just started to notice. Just over the last couple of days I’ve started to feel much better. I even managed to force myself to vacuum. I had to take a couple of breaks even though I only did the living room and a couple of bedrooms. It’s amazing how much a place can fall apart when you’re spending your time being focused on cancer, chemo and all that crud. Hiring someone to help with housework has helped immensely. I was worried we were going to have company drop by and they’d see how much cat hair was on the living room carpet, so I needed to get it done and it couldn’t wait for my wonderful housekeeper.  

 

I’m hoping I’ll continue to get my strength and energy back (the little amount I do have) so I can get some weeding done in the garden. Our yard has NEVER been this over-run with weeds. Having a summer with all this crazy rain has helped with their growth, yet made me cringe every time I walk around the yard. Thistles, pig weed, chickweed, portulaca and baby elm and maple trees stare boldly at me from every angle and every flower bed. It’s like they’re taunting me because they know I haven’t been strong enough to be out there to yank their ugly roots from the soil. Over the last few days I’ve managed to pollinate a couple of pumpkins, so hopefully they’ll have time to grow to jack-o-lantern size. Now I just need to find the strength to pick the beans that are finally starting to ripen. The garden is finally starting to produce some fresh vegetables for us to eat and the timing couldn’t be more perfect.

 

 

Anthracycline Extravasation, 8 weeks post-incident (arm update!):

 

Time is creeping by SO slowly with respect to my left arm and it’s healing – but I knew it would be a very long process. I’m not a very patient person when it comes to something like this. It’s been a little over 8 weeks since the chemo seeped into the skin around my port, causing a chemical burn under the skin. I’m now able to shower and even go swimming if I’m out at the lake, but I have to carefully and quickly dry the area. I’ve kept it shielded from the sun so I don’t burn it on the outside too. The area is still tender to the touch, and hot, but it’s changed color. It’s now brownish instead of red/purple. It is slowly decreasing in size, but after 8 weeks it’s still not healed.

 

Sometime in the next few weeks I’ll have another port put in. We’ve requested another arm port, and this one will be in my right arm unless the surgeon can somehow insert it higher above the old port. I don’t think the area around the port in my left arm has healed sufficiently for them to remove it yet, but my oncologist thinks they may try to remove the tube that is attached to it, because it comes out near my heart. Apparently, doctors don’t like it when there are 2 tubes in that area, so we’re assuming they’ll want to do something with the old port. I’m hoping they can make a little incision, cut the tube & suture the end that’s still attached to the port and then remove the rest of the tube. Once the area immediately around the port has completely healed from the extravasation, then they can remove the old port.

 

I’m extremely nervous about the procedure for the new port for some reason. Ok, I admit – I’m scared. I’m so scared I’ve asked my husband to be there with me. The port in my left arm was put in over 10 years ago while I was still in the halo and I don’t remember much. I don’t know how they do it now and how I’ll be feeling after, and I’m scared of being awake while they’re cutting into me to insert the port in my arm. I need him to be there for me, even if it’s in the waiting room outside. I really hope I’ll be given a nice big dose of a “happy drug” to get me through it and blur my memory because I know I’ll be conscious for the procedure. I just hope I’m stoned on legal drugs the entire time…and that I don’t swear at the doctors too much J