Yesterday I was awarded my certificate of Chemotherapy completion and a nice fuzzy blanket for completing 4 rounds of TC (taxotere,cytoxan) over 9 weeks. Even though when I finished my final infusion, I really just wanted to get the hell out of there, my eyes swelled up with tears as the Huntsman infusion room staff presented me with my certificate and sang me a song. I am so happy and relieved to be done and I hope that the next few weeks go smoothly. Basically, the drugs given to me yesterday will be in my system for around 3 more weeks and then my body will officially be able to start healing.Overall, my final chemo infusion was pretty uneventful. I started a few hours earlier than usual which meant that I was on the bike a little after 7:30 AM to ride to the hospital. It was a beautiful morning and it felt so good and empowering to ride in. A little dirt therapy prior to a long day in the hospital works magic on the mood. My long day started with an appointment with my plastic surgeon. Over the past month, I have been busy consulting with 4 different plastic surgeons; I think I have a pretty good grasp on ALL of the options available to me and am getting closer to making a final decision. I am tentatively scheduled for this surgery the middle of August at Huntsman. I promise to do a complete post on this.
After meeting with the plastic surgeon, it was on to having an IV placed, blood drawn, and meeting with my medical oncologist. My oncologist is out of town so I met with her nurse practitioner and nurse. My labs came back almost great. Red blood cells, white blood cells, liver, and kidneys all appear to be maintaining levels and functioning very well. My bilirubin was slightly high, which (I think) indicates that my liver is working extra hard to metabolize the chemotherapy drugs, but I was cleared to go on to the infusion room later in the day.
During this appointment, I had a lot of (what I thought) were interesting questions for the oncologist. First, I wanted to better understand how my red blood cells are affected by chemotherapy. Basically, my bone marrow (which produces white and red blood cells) is being suppressed by the chemotherapy drugs. The Neulasta shot I take the day after infusion helps with white blood cell production, however does not help with red blood cells. My bone marrow will be suppressed for approximately 3 more weeks and then it takes up to 120 days for my red blood cells to be replenished. Even though my red blood cells are considered in the normal range right now, they, along with my hematocrit values are significantly lower than what they were prior to chemotherapy. I hope that as my levels improve, my strength and speed on the bike improves as well. 120 days is a looooooong time!
I also discussed with my oncology NP my final reconstructive surgery. She recommended to wait 7 weeks from today for final reconstruction. Although waiting this long is not ideal (drags out the process), I am willing to wait to make sure my body is completely recovered from chemotherapy prior to surgery. I am tentatively scheduled for August 15th. Recovery from this surgery should be fairly quick, and I should have absolutely no restrictions after 3 weeks.
Today's actual infusion was uneventful. I was given the IV benedryl first which immediately put me to sleep and once again I slept through most of the infusion.
Now that I have finished chemotherapy, I get a 3 week break before I start Tamoxifen. This medication is pretty mush as effective as chemotherapy in reducing my risk for local and/or distant recurrence. Tamoxifen is an antagonist of the estrogen receptor in breast tissue. According to Wikipedia, "Some breast cancer cells require estrogen to grow. Mine is estrogen receptor positive. Estrogen binds to and activates the estrogen receptor in these cells. Tamoxifen is metabolized into compounds that also bind to the estrogen receptor but do not activate it. Because of this competitive antagonism, tamoxifen acts like a key broken off in the lock that prevents any other key from being inserted, preventing estrogen from binding to its receptor. Hence breast cancer cell growth is blocked". I will take a daily pill of Tamoxifen for the next 5 years!
In the meantime, I haven an appointment at the Cancer Wellness House for Therapeutic Touch on Monday and my weekly acupuncture on Tuesday. I plan to meet with the naturopath to work on completely detoxing my body after about 3 weeks. I'm also looking forward to a highly recommended detox acupuncture appointment. Also, since I have the next 6 weeks off work, I plan on scheduling free appointments for therapeutic touch, massage, and craniosacral therapy at the cancer wellness house.
I'm also looking forward to my hair growing back in. I still have quite a bit of 'fuzz' on my head, but I plan on shaving it down and taking some photos before it starts growing back in. As for other hair, I have so far kept my eyelashes and eyebrows. My leg hair has thinned significantly but grows quite long. I actually had to shave last week. I haven't lost a single arm hair, son of a......it hurts whenever they take my IV out. How long will it take for my hair to grow back? Who knows. I can't believe how slow Shannon's hair has been growing back though!