First Day of Chemo (... a piece of cake)

Well, not quite as sweet ... apart from the slight metal taste AC (Adriamycin and Cytoxan) left in my mouth right after, it was more or less a piece of cake yesterday. I forgot to take a pic while sitting in my fancy recliner chair hooked up to the tubes ... so instead, I've attached a picture of my arm port through which I will get my regular chemo infusions. I had the port placed 4 days ago and it still looks a little bruised and nasty, but it's not painful and it gets better with each day. It sort of feels like having a small watch battery on the inside of my upper arm ... as a kid, I always wanted to be the Bionic Woman ... so now I have back-up battery power! I will have my stitches out next Tuesday, Nov. 7th. Normally, the port is placed in your chest and they make a slight incision in your neck as well to feed the catheter ... I politely declined and insisted they put it in my arm instead. No, I haven't been the easiest patient. Would MUCH rather have a small arm scar to look at than a chest scar. Call me vain ... but I live in Miami where spaghetti string tops and strapless dresses are all the rage ... year round!

I was unsuccesful in my attempts to have my oncologist switch me to a different chemo cocktail ... one that would not include Adriamycin which can have potentially taxing effects on one's heart function, causing permanent cardiac damage in some people. I was assured that age is the biggest risk factor and with me being so young (yes, still young by oncology standards), I should tolerate it well. My MUGA scan (which tested my heart strength) was at baseline 67% ... sounded like a D- to me, but they look for your heart function to be betwen 50 and 55% normally ... so my heart strength is actually pretty great. I will get one of these scans every 3 months to monitor me closely.

My oncologist walked in yesterday, jokingly addressing me as "Doctor" since the day before I faxed her a long cover letter along with several power point slides from a recent clinical trial presentation held in San Antonio. At that conference, they outlined the results of a study performed over 2 years which showed women who were co-amplified (or tested positive) for a protein called Topo-II had a much better response to Adriamycin than did women who were Topo-II negative. My breast surgeon recently used me as a guinea pig (since the Topo-II testing is not routinely done) and discovered that I am Topo-II NEGATIVE. On that basis alone, I felt I was a much better candidate for another chemo drug called Carboplatin which does not have carry any risk of cardiac toxicity like Adriamycin. Still, my oncologist wouldn't go for it and even presented my case with this finding to Dr. Howard Burstein, a famous oncologist with the Dana-Farber Cancer Institute in Boston. He agreed with her that because of my "young" age and the fact that I am being given chemo in the neo-adjuvant setting (meaning BEFORE any surgery), that they must use the most aggressive, active agents that we have today. The clinical trial I discussed before was focused on women who had already undergone surgery first (lumpectomy or mastectomy) followed by chemo. I felt better after our talk ... I just really needed to hear Dr. Perez, my oncologist, justify to me one final time why I had to have the chemo cocktail which included Adriamycin. She did agree with me that the recent identification of the Topo-II protein will provide some future implications in the advanced treatment of breast cancer, but more empirical data is still needed ... and we only know what we know today, so she's sticking to the protocol.

All the infusion nurses at my chemo center are GREAT. Really lovely and fun ... they kinda remind me of ... well, ME! Ha, ha. They gave me nice, heated blankets to keep me warm and make me feel quite at home. I think I kept them entertained yesterday ... the Ativan (an anti-anxiety med) I was given through my IV probably had a lot to do with it too. I tried to order a French Martini with a splash of sweet and sour as my first chemo cocktail ... but they weren't going for it ... so instead, I got a bag of saline to flush my port first. Not quite the same, but hey. Also, the Ativan left me with a tired, drunk feeling ALL day long (practically all night too). Just wanted to sleep, sleep, sleep ... and I barely remember phone conversations I had later on. Just bits and pieces. I think I'm going to decline the Ativan next time ... why have it if I'm not even feeling anxious??

Just glad there's no nausea or fatigue today. I have been staying hydrated and eating well ... fruits, protein, veggies, and yogurt (to keep good bacteria lining my intestines) ... just trying to stay ahead of any potential nausea, diarrhea, and constipation. So far, so good. I hope chemo is working on killing the BEAST though! I decided to stay home from work today ... for no reason at all. Just figured I'd make it a long weekend. (tee, hee) Plus, I really want to go vote today and take advantage of shorter lines before Tuesday! Remember, if you haven't voted, you have NO right to complain. Stepping off my soapbox now.