Last Chemo/dr. visit Yesterday 10/2 and today

Hi all,
I felt so phenomenally good yesterday it was WOW. When I woke up I just wanted nothing more than to go and run, so I did and it felt great. Well, I didn’t exactly run all of the 30 minutes but I rand for about ten straight then alternated walking and running for the rest. It was my best showing in a long time and it felt so liberating and wonderful. I even went to the gym without my do-rag becaue I had forgotten it. Oh well, who cares other than I don’t have something on my head to sop up the sweat.
After I came back, I got cleaned up and headed out for my appt with Dr. Luke/bloodwork and my last chemo. I was still so excited and energetic I could hardly stand it!
My blood looked good and I didn’t need any shots. Dr. Luke still thinks that I should be in good shape for surgery so that’s great news.
I asked him about a few things:
1) I’m scheduled to receive herceptin (her2/nu killer via IV that I have to take for a whole year every three weeks) on the 23rd but I’ll be in LA so how can I work that? He wrote a letter to Dr. Silverstein so that I can get it somehow up there at USC/Norris while I’m recouperating. I may not feel up to going to the hospital on the 23rd but sometime that week is fine because the half life of herceptin is kind of long so it won’t matter if I’m a few days off or even a week. At first, Dr. Silverstein asked me just to have Dr. luke give him an order for the drug so that I wouldn’t have to go see an oncologist to just have my treatment, but Dr. Luke said it probably wouldn’t fly b/c I’d have to take it in some oncologists IV room or something and they’re not going to just take an order from some doctor that they don’t know. So, I’ll have to follow up on this by calling Dr. Silverstein’s office and figuring that out with his coordinator, Constance.
2) I did some reading on the internet about the side effects of Herceptin because I did some reading about Taxotere (the chemo drug I’ve been on the last four cycles) to see if there was some kind of fever/chills/flu like achiness associated with it. The only thing I could find associated with Taxotere was that, due to a drop in white blood cells, I might experience neutropenia (a fever induced by a low white blood cell count) but each time I had the fever on days 3,4,5 after the infusion, and not where my whites would bottom out. So….I checked out Herceptin and, although Dr Luke said when I first had it administered that there would be really no side effects from it, apparently Herceptin can induce a fever/chills and aches. So, I discussed it with Dr. Luke and he said it’s possible, but it could also be possible from the drug interactin between the taxotere and the herceptin at the same time and the only way that we can tell is when I have herceptin by itself in a few weeks. However, since the administration of the drug seems to be a little different every time, maybe it won’t happen at all J That’s what I’m going for anyway…
3) I asked him about follow up and discussed the radiation with him briefly. We’ll talk about radiation oncology when my final path results come back after surgery and when I have another infusion of Herceptin on 11/13 that I’m scheduled for (6wks from now). That way we can look at that to see if it’s something that we’ll still need to stick with. Regarding follow up beyond surgery to detect for recurrence, he said I should talk with Dr. Silverstein about what he recommends. Dr. Lanskowski from the breast center here suggested I do yearly MRIs to check things out because it’s really thorough but is also thorough to the point where they’re tend to be false positives, too (which I had the first time with MRI since there were two on the left that were benign). The reason that I need follow up is that it is impossible to assure that the removal of the breast tissue is full and complete, so that’s why follow up is necessary. In addition, we would want to make sure nothing came back in the lymphs. Not that I want to even talk about that possibility, but I want to be on top of it. My sense is that follow up instructions/directions might vary from doctor to doctor and since MRI is a more expensive test than others, perhaps that’s why Dr Silverstein didn’t recommend it when I asked him about follow up. He just mentioned yearly clinical exams by the doctor to feel for abnormalities, but I don’t think that’s thorough enough, so I’ll bring it up again when I see him.

Chemo infusion was great and I had the back room virtually to myself, which is nice since Karen (my friend Karen Pendleton also a cancer survivor) and Chrissy (my friend Chris Wong) both came to keep me company for part of the time. Chrissy brought me a lunch, which I requested, with PB & J, a peach, animal cookies and tortilla chips- a total kid/comfort lunch. She cracks me up and I just love it. Karen was so sweet, literally, and brought me a cookie by design. I don’t know if you’ve ever seen these but they’re gourmet fancy cookies with designs on them that are packaged very nicely. You can even order bouquets of cookies. It’s a really cool idea. Anyway, she brought me a butterfly design along with a balloon that said “congratulations” and that was so unexpected and sweet. I just loved it. It was great to visit with them while I was there and, since the process is so long, I’m glad that they didn’t have to be there the whole time but could just leave when they felt like it. I drove myself to and from the infusion. When I got home I was totally wiped and took a nap for a few hours. Then, woke up and watched North Country, an Ellen show that had Sheryl Crow on it for breast cancer awareness week and started reading yet another book called Reconsructing Natalie which my friend Glynis gave me last night when she brought over some fruit for me about a young woman going through breast cancer discovery and bilateral mastectomy/reconstruction. It’s really funny and light reading and adds a human element to what’s going on that is different from all of my other reading material. I tend to read about 2-3 books at a time so it’s nice to have some variety. It’s a great book and not something I would normally read.

Well today I’m not going to go to the gym but going to use my energy to clean up the house and work on some of the little projects that I have here as well as return phone calls, e-mails, etc. Oh, and go to get my nulasta shot (white blood cell booster) I’ll probably go for a walk, too just to get some exercise outside before it gets too warm, but that’s it.

Enjoying the time that I have :-)
Blessings,
Julie