Tuesday, August 13, 2013

Chemo #2, numbers, and radiation....

Last Tuesday's treatment was uneventful.  That is always a good thing.  Despite it being an "uneventful" infusion, it was still a long 5.5 hour process.

For those wondering, here's what a "typical" infusion day looks like:

-Arrive to hospital (via bike of course:)
-Shannon meets me there with car
-Secure bike on car

-IV placed, blood drawn
-Vitals taken by Medical Assistant
-Meet with Oncologist who does a physical exam and reviews lab work
-Get cleared for treatment
-Oncologist orders medications
-Wait for medications to be prepared
-Receive ~one hour of anti-nausea IV medications
-Chemo starts
-1.5 hours later go home

That's it.  Honestly, just typing it makes me a little sick to my stomach, but perhaps that is because I am still a little sick to my stomach!

Anyhow, as I've mentioned before, the first week after chemo is the hardest and this time was no exception.  It pretty much went exactly like last time.  However, I was prepared with toast, applesauce, NadaMoo dairy free ice cream, and pumpkin protein cookies.  The good news is that I seem to be rebounding from chemo #2 similarly to chemo #1.  Sometimes the effects can be cumulative, so I'll take the same!

Being a numbers person, I have been closely tracking my blood counts.  I even made a nifty chart with some of the more significant values.

Blood Counts
Target Ranges

>1 in treatment

>1 in treatment



RBC count

Mean Corpuscle Volume
<98 in treatment


Protein Status



Total Protein
>6.6 in treatment

Electrolyte Balance




Kidney Health





RBC Distribution Width

The "ranges" on my chart are the ideal ranges that my Nutritionist and I are targeting.  "Normal" ranges are a bit more lax.

Here's my interpretation:
-My white blood cells are a bit low, but still in the "normal" range.  This is despite not getting a Neulasta shot to help support immunity.
-Oddly, my red blood cell count, hematocrit, hemoglobin, and platelets all increased after my first treatment.  I am taking whey protein and chorella to help support my red blood cells, however I still find this odd.  Regardless, I'll take the little boost!
-The one value that I find a bit concerning is my BUN (blood urea nitrogen), which is an indicator of kidney health.  It is lower than what we are targeting, however it is still in the low "normal" range.  Other kidney health indicators look good, however from what I understand this value can also drop if your body is using more protein than it is getting.  I suspect this may be the case with me as chemo significantly increases your protein needs and I have been exercising routinely.  I will continue to focus on improving my protein intake.

In other news, I met with my radiation oncologist today.  I really like her.  If everything stays on track, I will meet with her again on October 1st where I will get measured and molded in preparation for radiation.  Even though I am going to get a crap load of radiation-boooo-they are extremely precise with their target areas.  My doctors typically have a hard time surprising me as I usually go into my appointments very well researched, however today I was surprised to learn that they will create a mold around my body that I will lay in for each radiation session so that I am in the exact same position.   Actual radiation will start the week of October 7th and will be daily for 5-6 weeks.  I was so psyched to "get out of" radiation back at my original diagnosis in 2011, however I know that it is 100% indicated this time around, so my plan is to move forward optimistically and see where the chips (i.e. how it affects my reconstruction) fall!

Photos from the week can be found here and weekly exercise here.


  1. Why no neulasta this time?

  2. And another question, why not hemp protein instead of whey?

    Thanks and keep up the good work


  3. Judy, Since my treatments are 3 weeks apart and WBC typically bounce back in that amount of time, we decided not to do Neulasta. It is just another drug, messes with the bone marrow, and has yucky side effects. It is always available if needed though. If my treatments were every two weeks it would be mandatory.

    As for the whey, I am just doing it during chemo/radiation This is the reasoning according to my nutritionist:

    "studies show that whey selectively steals glutathione from tumor tissue, making the tumor more susceptible to effects of chemo (Kennedy et al,, 1994, 1995). It may also help boost hemoglobin levels in cancer patients.
    I will switch to a vegan protein after treatment especially because I'm hormone receptor positive!

    But I think you're right. I should add some hemp right now too.

    Are you done? Hope all is well! Jen.

    1. One more round on the 26. Then done! Well, onto rad that is. I've just recently started hemp and its been awesome. I think my fifth round was the easiest if you can believe it.

    2. So about neulasta again...I don't think I could get away without it. Dealing with patients and the possibility of getting infections would scare me. Do you get any flu symptoms? What about healing wounds?

    3. I haven't had any flu symptoms. My oncologist says the bigger concern is bacteria that gets on my body, cuts, etc....Although my WBC have not tanked I do take precautions. When mountain biking I try to wear sleeves on my arms and long socks as I'm constantly brushing against trees and weeds on my legs that cause small scratches that I normally wouldn't even think twice about. That said, I did have one 'little' crash and had some scratches on my leg that seemed to heal up just fine. Phew! I had one day last cycle where my lymph nodes in my throat seemed swollen, but no sore throat. No flu-like symptoms......yet. It will be a little tricky now that I am back to work in the public schools. Will do my best to avoid sick folks.

    4. I think the worst thing for me has been the fear of the unknown. I get hot and wonder if I have a fever. I feel something not perfect in my stomach/digestive tract and wonder if I should stay in the bathroom til it goes away. I feel a little tired and wonder if my hemoglobin has tanked. But overall, all things considered, so far chemo has been easy. I missed a day of work each (planned-used vacation) for treatments 3-5 and have two scheduled days off for the last treatment. My legs get sore and I get winded easy when I work out....but I'm working out. Sometimes I get restless legs when going to sleep but Tylenol makes it disappear. I've put on weight, about 7 pounds so far since start in May, but I consider myself lucky I have an appetite. I eat super healthl, stay active and I am positive and it makes all the difference in the world. I get regular massages and acupuncture too. I am getting just about all the treatments out there for this, 6 rounds of taxi-tree (what my phone changes taxotere to) and carboplatin, a year of herceptin, rad, tamoxifen, all this after lumpectomy and sentinal node biopsy. I'm glad I am getting everything. Bring it now and all at once so I can live the rest of my life without it! It was crushing to see you do this again. But you know what I say that you can say too? Why NOT me? I'm young, have good insurance, I'm strong and it will make me a better person.

  4. I had Dr. Kokeny, curious if you got the same "dream team" as Vicky called the team back in the day. Plan on layering your clothes during rads time! You are going to be greasy with the Aquaphor, but follow the greasy instructions, my skin healed with very little leftover "tan." They took good care of me, the radiation team is a lot of fun. Plus you get to brag about all of your wicked tattoos (which look like little block moles, which have freaked out a random unsuspecting med student thinking I now had a very bad case of skin cancer, poor lamb). I managed to get the first appointment of the day so I didn't get stuck in the waiting room, in and out and off to work!

    1. Yep, I have the "dream team" too:) Really like her, she is very thorough and thoughtful. Hey, did they do a mold to your body too? Not that I'm psyched about rads, but the mold sounds cool!

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