Chemotherapy Cycle 2

How is it that three weeks went by so fast and it’s now time for my next round of chemo? 

Before I get started on chemo round two, I wanted to share with you three updates. 

Update one, my axillary lymph node biopsy did come back positive for cancer.

My surgical oncologist sent me the following message, “The lymph node is positive for cancer as expected.  This is helpful for us to monitor your response to chemotherapy which I see has started already.  We will discuss how things are responding and your options at your next appointment.”  

“Well sh**... No real surprise there, but I was secretly hoping that since they said they couldn’t palpate it on exam,it wasn’t going to be involved.” I thought to myself as I viewed the report and her notes. 

“I wonder what she means by ‘explore your options?’ Will I have too many lymph nodes removed during surgery and therefore need lymphedema therapy?  Should I just sign up for continuing education now so I can do it myself?” I pondered while looking up classes that are available for lymphedema management.  

Update two, I had a multisequence, multiplanar Magnetic Resonance Imaging (MRI) of my abdomen with and without contrast with Magnetic Resonance Cholangiopancreatography (MRCP).  An MRI MRCP produces detailed images of the hepatobiliary and pancreatic systems, including the liver, gallbladder, bile ducts, pancreas and pancreatic duct.

Since my bilirubin levels were elevated during the last two lab draws, my gastrointestinal doctor wanted to make sure I didn’t have any constrictions in any of my ducts that would cause these elevated numbers.

For those of you who haven’t had the pleasure of having an MRI yet, CONGRATS! 

I can’t believe how loud and aggressive they are. Aggressive from the standpoint of the noises and banging sounds they produce.  AND I CAN’T HEAR!

I always have them play 90’s music over headphones, but trust me, sometimes Boys II Men or New Kids on the Block couldn’t even keep me settled…and that’s saying a lot!

Anyways, I am happy to report that everything came back normal.  No abnormalities found.

“Phew, one less thing to worry about!” I stated, relieved that I could go back to focusing on “just breast cancer!”  

Update three, I started acupuncture the week prior to my second round of chemotherapy.

Acupuncture has been shown to help with so many symptoms that often follow chemotherapy. 

I will talk more about this in detail later.

Okay, now onto Chemotherapy Cycle 2: 

ROUND TWO DING Here we grow….

I started my fast Sunday afternoon, around 12:30 PM in preparation for my chemo on Tuesday.  

Tyler went to Willy Street Co-op and probably purchased all their vegan options available for my last meal.  It was all so delicious but my favorite was their tofu sticks which I dipped in marinara sauce.  YUM!  

It was so challenging to begin the fast again because my sense of taste and ability to eat had just started to return but I knew the mission at hand, STARVE THE F***ING CANCER!  

From 12:30 PM Sunday on, I only drank water, zero sugar gatorade and vegetable broth.  NO COFFEE!  

My mom made me homemade vegetable broth this time around which was more flavorful and of course comforting.

I prepped everyone in the house once again, “Listen, Mom isn’t going to be eating for a couple of days to starve the cancer for my next treatment. TREAD LIGHTLY. I’m going to be crabby.  YOU HAVE ALL BEEN WARNED!”

Just like last time, the first 24 hours of the fast were the hardest and then after that it seemed more tolerable.  

Here are the strategies I used during fasting:

1. Get plenty of hydration

2. Keep activities low and to a minimum, no overexertion

3. Use of sugar-free chewing gum (LIKE TONS!!)

4. Visualize the cancer cells leaving my body

I’m not going to pretend that it isn’t challenging to smell all the good foods and to watch your loved ones eat but the story I tell myself is, “this is what I have to do, to get to where I want to go…” 

AND where I want to go is literally wherever my family is for the rest of their life, for as long as I can and so…..”WE STARVE, WE STARVE THE MOTHERF***KING CANCER!”

“DIE YOU WORTHLESS PIECE OF SH**!” End rant.

Moving on, I was a little nervous for Tuesday to come around because I needed to have my port put in prior to my second chemo appointment. 

Tyler would spend the entire day with me at the hospital due to my port placement and the need for some extra help in getting to my appointments after the procedure because I would have weight restrictions and be a little loopy.   

Tyler and I arrived at the hospital at 7:00 AM and they called me back immediately for pre-op.  

I need to stop and take a time out here because I just want to say that ALL the staff that interacted with me back in the Radiology department for my port placement were fabulous.

Literally everyone was so thorough, kind and validating throughout the whole process it made it a lot less scary.  

Time in. 

Okay, so I didn’t know what to expect with my port placement but basically the port was inserted under my skin near my jugular vein in my upper right chest (since the cancer is in my left).

During the procedure, I laid on my back with my head and neck turned towards my left, they gave me medicine to make me loopy and said I might be asleep but I was awake for it all.

They numbed the area above my chest and neck well so I didn’t feel any pain, only pressure.  

On one occasion, I said that I felt it and then they gave me more medicine.

They peered over at me under the drape and said, “Oh, you are still awake? How are you doing?”

I replied, “I’m doing great, you can keep going. I’m fine.”  

After my port placement, I met with my medical oncologist who shared with me that my labs were all good.  

“Phew, what a relief.” I said. 

During the physical examination of my breast it was shared with me that my tumor was starting to shrink and become softer.

“What?! After only one treatment!  That’s AMAZING!” I exclaimed.

Next up was chemo.  We only had to wait for nearly an hour this time around before we were roomed. Not bad compared to last time.

During my port placement, they left the needle in so that I could get chemo through my port.  

I wasn’t sure what to expect or how it would feel having the chemo drugs go in through the port but it was relatively uneventful.

Since this was my second chemo cycle and I had no reaction during my first, I could get my HER2 targeted chemo drugs (Perjeta and Herceptin) together which would take a little time off my visit.

When it came time for the harder more systemic chemo drugs to be administered, Taxotere and Carboplatin, I was ready with my ice to begin cryotherapy.

I brought my own ice packs in a cooler. Thanks Amy once again for the encouragement! 

On Amazon, I purchased socks and mittens that were especially designed for cryotherapy which were relatively easy to apply. However, it did get quite cold so I had lots of blankets and my coat for warmth.

Tyler put on some good ‘ol Ted Lasso for me so I could laugh my way through the cold.

Do you know that if you smile when putting your hands in ice, you can withstand the discomfort for much longer than when you frown? For real, look it up.

After my chemo drugs were all administered, the nurse went over care and management for my port placement.

It was stressed to me that after she pulled the needle out, the port wasn’t to be accessed for 7 days.

In the shower, I needed to wrap up my incisions and avoid getting water directly on it for several days.  

“Got it!” I said, “No one can access my port for 7 days and keep it dry.” I restated back to the nurse.

And then we were headed home, home to my most favorite humans on the planet and to find out what symptoms would be in store for me during ROUND 2!

Sleep was a little challenging that first night due to discomfort in my head, neck and chest status post my port placement.

I was really hoping acupuncture would be able to help me out. I had my acupuncture appointment scheduled the next morning and I was not disappointed. .

My acupuncturist focused on healing my port incision areas along with the other negative symptoms of chemo that I had experienced during ROUND 1 (sores, GI issues, fatigue, etc.).

It was so relaxing that I fell asleep briefly during my session and noticed a difference almost immediately.

Do you want to know something else? I didn’t get as many sores or burning GI pain this round like I did during the first.  AND, my port area healed so nicely. 

I’m a believer and will be continuing using acupuncture in conjunction with my other treatment strategies.  

Here is a summary of my experience with chemo symptoms for Cycle 2: 

1. NAUSEA AND VOMITING: Unfortunately, this time around I did experience more extreme nausea with some emesis.  It would hit me in waves.  Looking back, I was probably dehydrated, though I kept forcing myself to drink fluids.  

2. FOOD AVERSION: I wish I could describe to you the way things feel and taste in my mouth but I’m afraid I don’t have the vocabulary.  My beloved coffee didn’t even taste good.  I would be so excited to try and eat some food and then I would get it in my mouth and I would be repelled by it.  

3. HOT FLASHES: Yes, you read that right, hot flashes. Fine one minute and then on fire the next.  Apparently, chemo is putting me in menopause.  FABULOUS (not)!

4. YUCKY MOUTH: I still had some sores in my mouth, mainly towards the base of my throat however, the taste and feeling that my mouth feels is repulsive. Lots of teeth brushing as well as using gum and mints.

5. RUNNY NOSE: My nose runs constantly!!  A constant freaking drip bucket.  I bend over and my nose leaks.  I’ve become my grandma and stuff Kleenex in every pocket and up my sleeve.  

6. TWITCHING/TEARY EYES: For those of you who know me, you know that my eyes have always watered but this is a whole new level of watery eyes.  Basically, I have tiny puddles collecting under my eyes regularly.  In addition, my left eyelid twitches constantly when I am awake and asleep.  

7. VISION CHANGES: I have been having difficulty seeing things that are close up as well as challenges transitioning: looking at something far away and then close up.  I have an appointment with an opthamologist soon to see what, if anything, can be done.  

8. FATIGUE: I feel tired, especially in the first week or so it's just an inevitable part of the chemo treatment. I would literally have to say in my head, “lift foot up, move ahead” during extreme periods of feeling exhausted.  

9. PORT PAIN/DISCOMFORT:   I had limited neck and head range of motion for the first couple of days after my placement.  Sleeping was uncomfortable as well.  

Around Day 10, I started to notice the familiar pep in my step and my inner thoughts and knowings began to surface once again.  

“Ahhh, there YOU are Ashley!” I would say to myself during those reassuring moments.

During the later part of Round 2, I went and tried on wigs at a very special place called, Lisa’s Healing Haven, which I have written a post about titled, “HAIR YOU ARE!” Check it out.  

I’m finding that It’s like a literal teardown and rebirth during each cycle and I’m reminded of a quote by Socrates, “ The secret of change is to focus all your energy, not on fighting the old, but on building the new.”

Mind, body and soul of mine, “I’m in awe and appreciative of the new you are building us each cycle.  Thank you.”