Well it is Wednesday, and time to start preparing for my second chemo infusion. That, to me, means some basic germ eradication in obvious places, washing and changing my bedding, and the dogs’ bedding, which lives on my bed, and doing some grocery shopping before my white blood cell count is up for eradication again.
It turns out none of these precautions were necessary for my first chemo cycle. I amazed my doctor with how well I did. I am not sure if it is because I did so well, or because he expected me to do badly because of the trouble I had getting rid of my drain. When I went in to see him on Day 7, he looked at my blood work and said, “This is from today? You had chemo?” My white blood cell count was 4.9 at that time, normal being 3.5 to 10, and chemo patients getting as low as 0. I was told that I would probably know if my count started getting low, because it makes you very tired, sometimes achey, kind of feeling like you have the flu. That is a very smart design feature, I think, that when you are most vulnerable to illness, you will not feel like doing things that will expose you to it.
Above is a Neulasta On Pro. This is attached to your abdomen or upper arm the day of chemo, and is programmed to inject medication 27 hours later to help boost your white blood cell production. It has flashing lights and beeps and clicks when it injects, and is very entertaining for grandchildren. 🙂
The nausea that everyone dreads when they are told they will have chemo is pretty well controlled these days with medication. You get two anti-nausea meds by IV before they even start the chemo, and there are three additional take at home meds, one for every day in the cycle, one for daily use in the first few days after chemo, and one for as needed. I never did use the third one. My nausea was mild and seemed to be directly related to food. The thought of eating most things made me nauseous. I kind of lived on toast and cereal for a few days. The vegan options I had made me nauseous to consider, by the way. I have to admit that by the fifth day my little vegan heart was craving chicken. I thought I would die if I didn’t have chicken and rice. So I did.
I also left my self imposed exile. As the days went on, I got to feeling better and better. In the first few days, I was a bit tired and needed to nap frequently, although on Day 4, I babysat my 15-month old grandson all day, and not only did I not get tired, it made me feel terrific. I’d stuck my head out into the world at the grocery store and it appeared that the recent late flu epidemic was subsiding, so on Sunday I actually gathered my courage together and went to church.
I was told by the nurse that administered my chemo that the first treatment is usually not so bad, that it is usually around the third treatment that you start to feel it, just because the assault on your system has worn you down. That’s also when you usually lose your hair. So we will see as we go on, but for the time being, it’s okay.
I am also ten weeks post mastectomy at this point, and honestly, that wasn’t all that bad either. The post-op pain I would classify more as discomfort than actual pain. The drains were an ordeal, and I kept mine for a record amount of time, but they were not painful. They were just annoying. The incisions have healed, although the scars are still pink, but I can look at the surgery site without it bothering me at all. In fact, if I’d had a double mastectomy, I probably could have lived without reconstructive surgery. Since it was unilateral, I will choose to go through that, although it sounds like the worst and most complicated part of the whole treatment.
I wanted to pass this message along for anyone else who might be newly diagnosed with breast cancer and facing any or all of these treatments. I subscribe to a couple of other breast cancer survivor blogs, and one is just full of woe. Absolutely everything she has been through has been intolerably painful, from the mastectomy to the chemo to the expanders in preparation for reconstructive surgery. She even said that the drains were so painful that every movement hurt. I can’t tell you how glad I am that I didn’t read that blog before my own mastectomy experience. It might make a difference that my plastic surgeon is excellent when it comes to pain mitigation. He is David Chang in San Francisco if ever you want any plastic surgery done. When he places an expander, he puts a shot of botulism into the muscle so it won’t spasm and cause pain. When I had my surgery, he administered a three-day local anesthetic. Now I took pain pills after my mastectomy, but you have to understand I do not have a high pain tolerance. In fact I have zero tolerance for discomfort. If I get a teeny tiny pain somewhere, I get out the motrin. So I medicated my post-op discomfort, but I don’t recall ever at any time being laid out by pain.
But here is another odd thing about me. This cancer this is not bothering me. I am not scared. I am not sad. I can’t really tell you why. I do have the most amazing skills in denial of pain, honed over 28 years of living as the parent of a kidnapped child. Perhaps it is nothing more than that. Pain? Block it out. But I don’t think it is. Is it my faith? Mmm, in a very general way that is a huge part of it I think. It’s almost as though I recognized cancer when it came along. “Oh hello. I was expecting you without even being aware of it. You and I have something to do together, don’t we?” It is also true that I am confident of my recovery, at least at this point in time. I have been told that my cancer is “very bad.” It is Stage 3C, the worst you can get before it is deemed uncurable. But at this point, it has all been removed. There were good margins in the surgery, and the PET scan was clear, so any cancer that is lurking in my body is small, cellular. I am confident that the chemo and radiation will eradicate it and I will go on to live another day, to walk down new roads and pass through secret gates I have previously passed by. I also kind of suspect that this cancer might one day kill me, either the breast cancer itself or a secondary cancer as a result of the treatment for the breast cancer. But I don’t expect that will be for awhile yet, and I’m not all that young, so I am not worried about it. I just want to make sure that I do not waste the time I am given.
The other thing is that I honestly don’t think that I am afraid of dying. I think part of that is denial as well. What can’t be cured must be endured, and you might as well do it with a good attitude. That’s how I have lived my life, and it will probably be how I end it as well. Plus I tend to think of death as a great adventure! I have my faith, my beliefs, but even if I am wrong I am not afraid of it. Even if the atheists and humanists turn out to be right and my heart and soul are nothing but biology that cease to exist at death, I won’t know. I won’t care. The only thing that has bothered me is worrying about my family. I don’t want anybody to hurt. I want to make sure everyone has what they need to get through, and to live a happy life. But I have learned that all of that is not really up to me. It’s been part of my life task in recent years to let go of my desire to advise and control circumstances in order to protect my children. I have learned to say, “They will be okay.” And they will be, no matter what. Even if they have some mountains to climb and rivers to swim, they will do it, and they will be okay, and they will be all the stronger for it.
I don’t want to make light of things. I know cancer can be a horrendous disease. I have been reading a book about man with cancer that metastasized, who underwent treatments that were so painful that he could not complete them. His cancer spread to his bones, which as a result broke when he sat on them. And my thought was, if you have to have cancer, breast cancer is much easier. They can just cut the things off. Unless you are planning on having babies, their only function is decorative, and current health law mandates that their decorative function be restored. But even breast cancer and breast cancer treatments can lay people low, I know. I may be one of them yet. I am in week two of twenty weeks of chemo. I should keep quiet until week ten, and then tell you how easy it is or isn’t. But meanwhile, I just wanted to encourage those who are starting out on this journey. Don’t be afraid. You can do it.