Chemo # 3/4-Check!

Yesterday was a pretty good day for infusion Friday. Woke up and generally putzed around the house before I rode my mountain bike to my first appointment of the morning with the plastic surgeon. My ride on the Shoreline trail was fantastic. I can literally ride dirt to the entrance of the hospital. I think I was also experiencing a 'Floyd' high as I had started my pre-infusion regimen of steroids on Thursday. I haven't felt this 'high' before, but for some reason, I was just giddy yesterday. Shannon was at the hospital waiting for me with the car so we would have a safe place to park my bike for the day.

Can I say, once again, best. husband. ever.

I was visiting with the plastic surgeon because the time is getting closer for my final reconstruction surgery. Yes, I have one more surgery after I finish chemo. As I have mentioned before, a temporary implant was placed at the time of the mastectomy. This gives my breast some shape and it also has a port in it that allows us to inject saline and slowly stretch the surrounding skin and muscle to my final desired size. We have expanded a few times and it seems to me that there may be some leakage. Slow leakage, but leakage none-the-less. This is only saline and is not dangerous to be absorbed by my body, but it does add a possible complicating factor in to my final reconstruction. Yesterday was kind of an experiment. My plastic surgeon inflated the expander himself and I will report back to him in a few weeks if I notice any leakage. Fortunately, if it is leaking, it is happening slowly and since I decided against the DDs we can probably get a way with a few small expansions right before my final surgery and be just fine.

If you're interested in what the expander looks like here is a photo:

The black spot is the port where saline is injected to expand. It is all under the skin so a magnet is used to find the port. Expanders are not the most comfortable of things, they're not soft like permanent implants, but I'm fortunate that my has become quite tolerable and I only occasionally notice it. This is all pretty amazing. I'm assuming that the 'small' size is what is in my breast right now.

This appointment went pretty quickly and since we live so close to the hospital, we were able to go home for lunch and 45 minutes of puppy play time. Dizzy was more into sunbathing though.

At 1:15 we were back at Huntsman for my blood draw, IV placement, and meeting with my oncologist prior to my 2:30ish infusion. My bloodwork all came back in the 'normal' range. I was psyched that my red blood cells and hematocrit were back to 'normal' and this added to my giddiness. White blood cells are holding up nicely thanks to my post-infusion Neulasta shots (these shots cost $7000 each! Fortunately insurance pays for them) and liver and kidneys continue to be working great as well!

At around 2:45 I was called back to the infusion room. Pre-infusion meds took a good 45 minutes. I got more steriods, anti-nausea meds and then we added IV benadryl and an antacid. I had a short reaction at the start of my last infusion, where my throat closed off and I got scared; these additional meds were to help combat that. They seemed to work, but they also put me to sleep. So much for my 'Floyd' high. I slept through most of my infusion. At 6:15 we were done, the IV was removed and we were on our way by 6:30. I was the last patient in the infusion room once again!

Today, as usual, I'm feeling pretty good. I'm being diligent about my post-infusion medication and I just got back from a delightful ride with Lyna on the Shoreline. It is a perfect day and we thoroughly enjoyed it. Now a short rest (for a few hours) and then it is back to Huntsman for my Neulasta shot. Tomorrow, I fully expect to wake up tired and achy, however, as much as it sucks, I must remember that too will pass. As usual, I will not consider myself officially 75% done until after my post-infusion hump week.

This week is looking to be perfect. Not to be selfish, but the weather looks to be crappy on my crappy days and then turn around and be warm and sunny just as my body hopefully starts to turn around as well.

'On the mend'

I was hoping that I wouldn't have to be 'on the mend' until after my 3rd infusion, but unfortunately this week did not go quite as planned. I was recovering from my second infusion as planned until Monday night. A few hours after dinner (Note: a dinner full of steamed veggies that was SUPPOSED to make me strong and healthy) my stomach started to hurt. As I was trying to fall asleep my stomach started to hurt so bad that I actually took one of my anti-nausea pills. Now, over the past six weeks I have NEVER needed an anti-nausea pill except for the mandatory days post infusion so I really wasn't feeling well. I had a terrible time falling asleep and by morning I was achy all over. I felt like I was back to day 2 post-infusion with an upset stomach as a bonus. Needless to say, I never made it into work that day and the highlight of my day ended up being a warm bath. The good news was that I had no fever. In fact, I was questioning the accuracy of my thermometer because my temperature was well below normal. Regardless, this was a relief. Anyone who has undergone chemotherapy has had it pounded into their head that a temperature above 100.5 is considered a medical emergency. Since my temperature was in the 96-97 range, I was not too worried.

Tuesday night my stomach was relieved. I'll spare the details, but it was not pretty. Not as bad as my epic food poisoning incident post Whisky 50 last year, but I did need to stay within 20 feet of a toilet for a couple of hours.

By Wednesday morning I was starting to feel better and ventured into work for a caseload meeting. Once at work I found out that quite a few of my co-workers were out with the flu, so now I'm not sure if it was food poisoning or the flu. I suppose it could be either as chemotherapy messes with your gut AND makes you more susceptible to viruses. Fortunately, I am certain that I am recovering and should be able to proceed with infusion #3 tomorrow.

Overall, I am happy that my body was able to recover relatively quickly from this little set-back and that I was well enough today to sneak a ride in on dirt.

There are a lot of epic cycling events taking place this weekend. My teammate Karen Potter is racing the Tran-Sylvania Epic Stage Race, a 7-day stage race in Pennsylvania. She finished second last year! Gunnison Growler is also this weekend. Shannon and I ventured to Gunnison to compete in this race last year. Locally, there is the Stan Crane Memorial race. This is one of my favorite local races on the super fun Corner Canyon trails. I will not be competing in any of these races, but I will be participating in my own personal marathon tomorrow. It all starts when I meet with the plastic surgeon at 11:15. I still have one final surgery that we will be discussing. Then I proceed to have my blood drawn and IV placed prior to my 1:15 appointment with my medical oncologist. My infusion is scheduled to begin at 2:30 and usually lasts a couple of hours, however I have never started on time so I plan on being at Huntsman through dinner. As has become my routine, I will get a little bit of dirt therapy in the morning.

After that I will be back to week one post infusion. The good news is that I will be 75% done!

No news is good news

Week 2 post infusion 2 seems pretty similar to week 2 post infusion 1. This week I worked, rode my bike, and even did some core/upper extremity work a few times. Don't get me wrong, this is NO walk in the park, however I feel fortunate that so far I am strong and healthy enough to remain somewhat physically active. For this my sanity is happy as well.

I am over being worried about my elevated B12 levels. Both my oncologist and naturopath say, "better high than low". Instead I will focus my worries, because of course I need to worry about something, on my red blood cell count. Prior to my last infusion, my bloodwork indicated that my RBC count was just below the normal range, indicating that I am slightly anemic.

Low red blood cells=anemic=low energy levels=can't ride my bike.

I am certainly not to that point yet, but I don't want to get to that point either. I have noticed that when I get up too quickly that I am dizzy, just like my puppy:) and a sign of anemia. There is not a lot I can do to control my RBCs, however I am trying to get plenty of rest and eat well. The moment of truth will be this Friday when I go in for my 3rd infusion and get a new set of bloodwork results.

Honestly, if this is my biggest worry at this point, I'm pretty fortunate. This is hardly worthy of a post. Like I said, no news is good news.

In cycling related news, there is the possibility that I may do a little bike race in October. This would be strictly for fun (as in I have no intention of 'training' for quite some time), but then again, bike racing isn't fun unless you are going hard:)

50% done

Even though my second infusion (halfway mark) was over a week ago, now that I am through week one of infusion #2(the hardest post-infusion week), I am officially considering myself halfway done with chemo!!!!! You can pretty much look back at this post to know how I've been feeling this past week. But to summarize.....

This time around, because I kind of knew what to expect, my odd side effects were not as alarming. My worst days for fatigue were once again Sunday and Monday. I still had (have) the tachycardia although like last time it is improving. It is pretty annoying and a bit scary those few days when you can feel (what should be) your resting pulse racing throughout your whole body. My pulsating low back pain was not as significant this time around. I think I did not push myself as hard physically those first few days and I have also learned that Tylenol really does help:) My skin seems much happier this time around as well and even though my mouth got all yucky again, it doesn't seem as bad as last time either. Honestly, I'm not sure if my symptoms really were less this time around or if I have just learned how to manage them better. Either way....I am 50% done!

The one thing that remains a mystery is what my red blood cell count is doing. Prior to my last infusion, my RBCs were slightly low, meaning I was slightly anemic. We did an iron panel to make sure I don't have an underlying iron deficiency. The iron panel results are back and my iron and total iron binding capacity are within normal limits. Although, interestingly, my B12 and folate levels are high. B12 is actually really, really high. I am not taking any B12 supplement with the exception of my daily vitamin. My oncology nurse was not concerned about this, but I plan on talking with my oncologist more at my next visit. If anyone has any insights, please let me know! Keep in mind that my liver enzymes and WBC are all in the normal ranges.

As for physical activity, I took it a little easier the first few days of the week. Partly because I knew my body would come around and partly because I was trying to work and I only have so much energy this first week. By Thursday, I felt good enough to go for a road ride. I rode up Emigration Canyon with this girl and felt surprisingly good. I think the good company helped:) I managed to ride dirt with Shannon both Saturday and Sunday. I'm still keeping my rides to sub 2 hours, but it was a beautiful weekend and it felt so good to be out.

Walk for the Cure

Last Saturday, the day after my second chemo infusion, was the Salt Lake City Race/Walk for the Cure. Almost 20,000 people participated in this event. It was truly overwhelming to see the endless pink train of participants. Our team raised almost $2000 for the cause. My sincerest thanks to everyone who donated or participated.

We met near the start for some pre-race beverages. Alcohol may or may not have been involved, but I stuck to the virgin OJ. One of my co-workers stayed up late the night before making team shirts. There was even a bike on the shirt. Very cool!

Team captain, Bob, preparing OJ

We then pretty much split up and walked, jogged, or ran full-out the 5k race. Shannon and I hung with a few of my co-workers who were jogging at a nice pace. I've raced my mountain bike for 100 miles, but I don't think I've ever run a 5k. I guess I can check that off my bucket list.

Shannon looking hawt in pink

Thousands of participants at the Gateway

By Sunday I was already starting to feel the post-infusion fatigue and muscle aches and Monday wasn't much better. The good news is that I'm already starting to snap out of it and am looking forward to feeling better each day for the next three weeks.

In other news, Shannon is now a skinhead, although in my opinion he looks like Mr. Potato Head.

The Good, the scary, and the funny in no particular order

This week started out a bit scary for me. On Monday I found out that one of my 'survivor' friends and mentors had found a new lump and she was going in for a MRI later in the week. This is an amazing woman that I deeply admire and I was devastated. If cancer could return in her, it can return in anyone. I immediately started (probably over) assessing everything that I felt in my body and convinced myself that the tightness I had over one of my ribs was concerning. Bone metastasis to the ribs is one of the most common places breast cancer spreads to. I spoke with my oncology nurse multiple times on Tuesday and we decided I would take Ibuprofen for the rest of the week and do an x-ray if it was still bothering me on Friday. The 'pain' I was feeling was weird. I only felt it when I would do certain stretches or when I would poke in a certain place on my rib. I was told to quit poking myself. This week was kind of long. I was a bit cranky and I was genuinely scared. On Thursday I found out that my friend's lump turned out to be nothing. I was ecstatic. Today when I saw my oncologist she thoroughly examined me and immediately noticed that when I did my 'stretches' that the sore area was actually a vessel. Not sure if it is a blood vessel or a lymph vessel, but who cares. This was great news. My oncologist said that this sometimes happens after surgery and she is not sure why. Nothing to be concerned about. No x-ray even needed. She recommended that I stretch, massage, and apply warm compresses and it should go away. I was giddy and could finally take a real deep breath. I then proceeded to spend 7 hours at Huntsman, most of it waiting, to finish my 2nd round of chemotherapy. I am a bit tired to say the least.....but very relieved. I truly believe that I can get through this journey and be as strong or stronger than ever before. It may take some time, but I believe. The one thing that I have to learn to live with is the fear of the cancer returning.

Other good news is that my white blood cells are maintaining good levels. Actually, my WBC level is higher today than it was before my first infusion. I guess that Neulasta shot is doing its job. My Hematocrit and red blood cells have dropped. Maybe this is why I feel slow on the climbs? My levels are just slightly low today, and hopefully they will not drop more. I don't get to be a doper either as my oncologist said that EPO can actually reduce the effectiveness of my chemotherapy drugs and I certainly don't want that. Worst case scenario would be a blood transfusion (is that doping?), but hopefully we don't get to that point. We did do an Iron panel today to determine if I have any underlying iron deficiency.

That was the scary, now for the good. Yesterday was the most beautiful spring day we have had so far. I actually was able to wear a short sleeve jersey on our bike ride. Shannon and I had a perfect ride on the Shoreline and he took loads of photos to remind me how good life will be once I get through my chemo hump days. Shannon always helps me feel strong on the bike by letting me ride just a little bit ahead of him. It almost makes me feel fast:)

Some fun photos from our ride:

Climbing grassy hill

Before the river on dry creek

Dry Creek should be renamed Creek Trail right now

My favorite photo: I love the snow capped mountains in the background

And now for the funny. Well, my hair is officially on its way out. I was shedding profusely for a few days and then on Wednesday we 'tried' to shave my head. Even though clumps were coming out, it was still too thick for our electric shaver. Shannon basically did a hack job on my hair, but there is still enough left that when I wear a hat it looks like I have hair. Thursday I wore a hat to work for the first time. I was at one of my schools and a teacher who doesn't know I have cancer said that my haircut looked soooo cute and she wanted to see it with my hat off. I didn't want to tell her that I had cancer and that my hair was falling out, and I certainly didn't want to show off Shannon's hack-job, so I said I had terrible bed head. It was kind of funny how persistent she was, but there was no way I was going to take my hat off! Even though it was awkward, I was giggling. I imagine I will have to get used to this over the next few weeks as my hair is quickly thinning and we are going to try shaving it again this weekend. BTW: Someone else in my family is getting a shave job and it is NOT Dizzy!

Tonight, Lyna brought over the yummiest meal from Mazza. My taste buds are still working (they probably won't be tomorrow) and it was truly appreciated. Thank you Lyna!

Tomorrow is the Race for the Cure and there are 20,000 people expected to swarm downtown Salt Lake City. I think we are going to park by the Hospital and take TRAX over to meet our team. I got this idea from Mandi another young woman who is undergoing cancer treatment. We've been supporting each other through this journey online and I finally got to meet her in person in the infusion room today. We both have to return to Huntsman for our Neulasta shots tomorrow in the afternoon.

I think I am going to go wear civilian clothes as opposed to the survivor t-shirt to the race/walk tomorrow. I am getting through this journey, but I certainly don't quite feel like a survivor yet!