Cycle #5

Cycle #5: the start of Taxol the notorious drug that brings on nueropathy. My oncologist  instructed that I take 5 pills of Decadron, a steroid, the night before and take 5 more pills the morning of each and every cycle from now on. The reason I have to take so many, as my doctor explained, is to prevent a severe allergic reaction from Taxol. My new drug is not supposed to cause nausea so there will not be many, if at all any, antiemetic meds.

As always, I arrived early in the morning to do my blood test to make sure that my complete blood count would allow me to have the chemotherapy.  The results came back acceptable and I was cleared for the next cycle.

Next, I was to go to see my doctor for a quick check-up before the chemotherapy. This is where I have my vitals checked and get to have questions answered that I have for my doctor. I, had a few questions to ask the nurse practitioner  and my doctor.

1.) My first concern was the bone aches that I have been having since Thursday.  The bone aches were limited to my legs and lower back, very similar to my usual premenstrual pains. My hip joints seemed to be more painful that usual as well. If I take a wrong step sometimes it feel like my femur will fall out of my hip joint. According to the nurse practitioner and my doctor this pain was most likely due to the chemo and not the cancer. This is somewhat relieving, since the last time I saw her I had a major scare of recurrence. To relieve the hip joint pain, its recommended to stay active, something that I have been slacking with.

2.) My next question was able taking multivitamins and Vitamin B12. Doctors usually do not recommend taking any vitamins at all. This is because #1 the day of chemo, the vitamins may interact with the drugs. There have not been any research studies about the interactions of vitamins and cancer drugs. Therefore it is not safe to take with vitamins on the day of chemo. Secondly, multivitamins that contain antioxidants will defeat the purpose of chemotherapy since the point whole point is to use the oxidants to kill the cancer cells. I decided that I would be taking the multivitamins but none that contained any antioxidants. Even though I eat healthy foods like organic veggies and fruits, very limited meats and lots of fish, I feel like I am not getting the necessary amount of vitamins that is required. I will be taking Vitamin B12 because it is supposed to help prevent the neuropathy that comes with my new drug Taxol. The side effect neuropathy presents as first tingling of the fingers and toes and the loss of sensation in the same areas. This is supposed to go away with time after stopping the drug.

3.) Going through the internet one can find a lot of misinformation regarding how intake of sugar and its affects/causes of cancer. Most of the information on these websites is not based on clinical or research studies. Even though this information is not coming from the right sources, this was something I needed to get a better understanding on. According to my doctor, there no clinical link between the intake of sugar and cancer. being that my final diagnosis was a subtype of Invasive Ductal Carcinoma, triple negative glycogen rich clear cell carcinoma, I was worried that excess intake of sugar would harm my recovery. The GRCC IDC is a rare subtype of BC, that is seen in about 1-2% of BC patients. So I wondered if all the fruits and sweets that I have been eating would affect my recovery. Luckily my doctor told me that the only kind of food that I should keep away from is animal fat. I can eat any meat that is lean and contains little fat.

4.) A few days ago I developed a mouth sore in the corner of my mouth on the left side first and then a day or two after on my right side. They hurt when I open my mouth to eat, yawn or open my mouth wide. However, when I put on chapstick and moisten the sores, it feels much better. Today I had to ask my doctor and NP what was going on. Unfortunately, I have developed cheilosis, which develops from either nutritional deficiencies, fungal infections or bacterial infections. Mine is believed to be a fungal infection and I was prescribed an antifungal medication, fluconazole to take for a week. Since my immunity is suppressed from the chemo drugs, it is very likely that I can develop an infections caused by an opportunistic pathogen. This fungus seems to be one of those.

5.) After my chemotherapy is done and over with, I will be need to be tested regularly for any distant or local recurrences as well as mammograms on my left breast for any new cancer. The testing will smart at the 3 month mark post chemo. It is still uncertain if I will have any testing done earlier since my situation is unique. My young age is especially worrisome.

6.) Next my Mediport. Thankfully, the chemo drugs are not administered through my veins but instead are directly administered into my circulation via the mediport. About two weeks after chemo I be allowed to remove the mediport. Finally, the bump that above my left breast will be gone and I will have smooth skin again. 🙂

As you can see, this week I had quite a few questions for my oncologist and the team that was treating me. It is always important to ask your doctor any questions or concerns that you have, no matter what illness you or a family member is going through. I highly suggest this instead of sitting around and wondering “what if” or resorting to the internet. Almost every case is different and every person responds differently to medications and disease.

After I was done with my Oncologist, my mother and I made our way downstairs to the Chemotherapy/Infusion Clinic. We waited for about 30 minutes for my private room, which would have a bed and some room for privacy. I brought my own pillows and blanket, today I would be in the infusion clinic for about five hours.

The first hour was dedicated to the two Benadryl IV bags administered, 30 minutes for each bag. Also another dose of the Decadron through the IV. The Benadryl made my very drowsy but at the same time was can make my legs feel restless. Well I can tell you that the benadryl put me to sleep really quick and I made good use of the bed that was in the room. I passed out. I laid in the same position without even moving. I remember my mom sitting quiet as a mouse, then my sister Anna entering and joining my mom in the quiet as a mouse game. My nurse Debby would come in from time to time and check that I was ok after hooking up the Taxol into the IV machine. I laid there for quite some time. I did not fall asleep as soon as my head hit the pillow, it took quite a few minutes for my mind to relax. My eyes felt as heavy as sand bags and I had no energy to move my body.

For some reason right after the benadryl stopped dripping and the taxol starting, I started to feel extremely nauseous. I was just as bad, if not worse, than the first three days of the first two meds, adriamycin and cytoxan. The nurse quickly got an IV bag of Zofran, an antinausea drug and added that to the IV machine. The taxol had to be stopped and the Zofran IV bag had to empty.

The taxol was dripping for almost three hours, for the first time it is recommended to start the drip slow so that no serious adverse effects like an allergic reaction would occur. After an hour or so of the taxol, I woke up hungry. Anna was nice enough to go pick up food with my dad from Acropolis, a greek restaurant in Buffalo. Although my mom packed some healthy fruit snacks, that was not satisfying my appetite. The administration of the decadron has some serious effects on my appetite and weight. On April 4 I entered the RPCI at 138lbs, today after 10 weeks of chemo, I am now 151 lbs. I have gained over 10 pounds since this whole ordeal. 🙁

As soon as I see the side effects of the new drug, I am joining pilates to get more active!! I have been so terrible with staying active during these ten weeks. I know its supposed to improve my nausea, fatigue and mental status. So I will go at it soon!!

My dad stayed for a few minutes before having to leave to run some errands. I was done an hour after he left. My mom, Anna and I made our way home. Mom went to pick up my antifingal medication and I drove back with Anna. The whole time in the car I felt nauseous, so when we arrived home I quickly took my antinausea pill, Compazine. It seemed to alleviate the nausea but is not working 100% to completely relieving the nausea.

Now I wait to see what kind of side effects this cycle will bring. Until the next time!!



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