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Survival Mode

I wanted to start off by saying thanks for all of the positive vibes and well-wishes you sent my way this weekend, especially on Friday, as I was getting my first chemotherapy treatment. And I wanted to give you an update on how that went. As I said in my previous post I was pretty freaking scared of chemo. Not only have I heard horror stories of how horrible chemo can make you feel but I just didn’t know what kind of experience to expect. I told my friend that it was like the first day of school and I didn’t know what to wear. Like I literally didn’t know what to wear. It was 90 degrees in DC and the hospital, in my experience, was about 47 degrees. Do I sweat on my way in or freeze through my treatment? What should I bring with me? Should I bring food? Will I feel too sick to eat? What will I feel like after? What will it be like during? I had a zillion questions and no answers. I just had to go in and do it and hope that I felt prepared.

Before I go over how it went let me explain the chemo plan: Because I am part of a clinical drug trial I will receive three different chemotherapy drugs over the next 20 weeks. Two of them, Taxol and AC, are commonly given for breast cancer but usually AC is given for a number of weeks and is then followed by Taxol. In my case I will get Taxol first, once a week for 12 weeks, and then AC, once every other week for 8 weeks, so 16 total treatments spanning 20 weeks. During my 12 weeks of Taxol I will also receive an experimental drug with the catchy name, MK-2206. It’s taken in pill form on an empty stomach one hour after the Taxol is administered. Now, supposedly the combination of Taxol and MK is not supposed to be too bad. They aren’t supposed to cause much nausea, hair loss is supposed to happen a little more slowly, etc. The effects are cumulative, however, which means that they get worse the longer you take them.  AC is supposed to be the real kicker. Most people have really bad reactions to that and all kinds of horrible symptoms. Doesn’t leave a girl a whole lot to look forward to does it?

First chemotherapy treatment

First chemotherapy treatment

Here is how it all went down: My husband, mom and I got to the hospital at around noon and met first with my medical oncologist. She was very patient and answered all of my questions. They then sent me up to the “oncology infusion unit” which is hospital code word for “place where they give people chemo.” I had been there once before to have some blood work done and I was thankful that I at least knew what to expect in terms of where I would be. The three of us squeezed into one of the curtained off “rooms,” I got the big comfy chair and the nurse told me the plan.  The first thing she did was “access” my medi-port. This involved sticking a long needle into the port that sits just underneath the skin on my chest above my heart. It didn’t hurt that much but there is something about being swiftly stabbed in the chest with a long needle that will definitely take your breath away for a second (you can see the accessed port in the photo to the right). She then took a few blood samples and moved on to the “pre-treatment” infusions which included steroids, Benadryl, Pepcid and an anti-nausea. These are all the “just in case” drugs to prevent allergic reactions and stomach problems. We then waited 30 minutes for those to kick in (while I passed out from the Benadryl that was just injected straight into my heart). Then she started the Taxol drip, very, very slowly. At this point they are very nervous about negative reactions so they go slowly and monitor any and all changes. About 15 minutes in I felt like I was all of a sudden gasping for breath so they all jumped into action, took me off the Taxol, started monitoring my vitals, tried to get me on oxygen, etc. The feeling went away pretty quickly but I had to wait another 20 minutes before they put me back on the Taxol. Once I got back on it I felt fine (aside from the Benadryl grogginess) and about an hour later it was done and I was sent home. The total chemo time was about 4 hours, which should be a little bit shorter next time since they won’t have to go as slow with the Taxol. I took my other chemo drug, in the form of a pill when I got home.

So far my primary symptom has been fatigue. I felt pretty lethargic on Friday night but felt even worse on Saturday. I could still get myself out of the house but even short trips were exhausting. Today, I still don’t feel 100% myself.  So I am guessing that feeling tired a lot is going to be part of the new normal. Since the effects of Taxol are supposed to get worse over time there are plenty of other symptoms to look forward to. Right now I’ll take just feeling fatigued.

So those are the logistics of it all. But I have also been dealing with the emotional side of this new treatment. Somehow, starting chemotherapy has shifted something inside me. The last few weeks the goal has been getting to treatment. Now that I am getting treated the goal is to fight this thing. This has somehow made the cancer, the threat, much more real to me. Triple negative breast cancer in a woman under 40 doesn’t look good on paper. I know that even after I get through the chemo and the surgeries and the radiation that there will still be recurrence to worry about, other kinds of cancers that could appear, lots of wondering and worries that could haunt me if I let them.  And so I have started to wage an internal battle. On the one side there is tremendous fear and a despair that could easily overtake me. But on the other side there is hope. I’ve have started to arm myself with the resources to emotionally survive the next year and to physically survive for as long as I possibly can. It’s survival mode now. I’ve got support groups, a therapist, guided meditations, yoga sessions, exercise, a cancer fighting diet, accupuncture, my naturopath, an incredible support network of friends and family, an amazing husband and an attitude that I hope I can keep positive through all the shit I’m about to encounter.  Crushing cancer right now basically just means one thing: remaining hopeful no matter what.