Chemo Round 3

I have a strong Christmas hat game.

I had my third round of chemo on Monday, December 19. I am now half way done with chemotherapy (unless something happens that requires us to change the game plan). Amazingly, I have experienced the fewest side effects with this round. I do not mean to give the impression that I feel great by any means, but I was a lot less dizzy on days 4 and 5 after chemo than I was during the first two rounds. Plus, I had much less bone pain on those days. My mouth got sore again on day seven (Christmas Day) but I was able to keep it from getting too bad by brushing my teeth (with Biotene toothpaste) after each meal/snack, using Biotene mouth wash and also the mouth wash prescribed by my dentist, which I use before bed each night. Biotene rocks.

The biggest negative change is that I am growing more tired and fatigued with each round of chemo. It makes me wonder how bad this will get by the end. In the immediate days after chemo, I am pretty bloated from the liquids given during chemo, plus the amount of water that I drink. (Every doctor, nurse, fellow chemo patient extols the virtues of drinking a lot of water to flush out the poison. I drink as much as I can given that water is starting to taste gross and ice cubes sometimes taste like garbage.) And, of course, when you drink a lot of water, you have to go to the bathroom a lot. Thus, I get up every two hours to go to the bathroom in the first few nights after chemo. Sometimes my pre-cancer insomnia comes back and I can’t get back to sleep after I go to the bathroom. By day 3 of this round, however, insomnia was no longer an issue. I’ve been going to bed at 8:30 (or earlier!) and sleeping until 5:20 am (if we do CrossFit) or as late at 7 or 8 if we do not. I sleep so long my back hurts from the inactivity. It could be that sleep has been helpful in alleviating some of the other side effects. Or, it could be that the chemo is starting to take its toll. Or it could be both.

Also, a troubling new side effect is that my fingers and toes are becoming sore and sensitive to touch. I’m hopeful that this is related to my fingernails and toenails becoming more brittle and is not the start of neuropathy in my hands, arms, feet and legs. Neuropathy is a common side effect of chemo. I had nerve pain in my right leg and foot due to my hip issues for many years prior to my surgery. I was on Gabapentin for at least five years. I just weaned myself off of it in January 2016. I’m hoping so hard to avoid neuropathy. Send me some positive vibes to avoid this. Dr. Coluzzi said that it will *usually* go away when chemo is done but sometimes it takes a few months.

I need to take a few minutes to discuss my hair. I shaved off the hair on my head several weeks ago. And I do have big bald spots on my head (including right above my forehead). But I also have areas where the hair on my head seems to be growing. In addition, I have one strip of leg hair that hasn’t fallen out, along with about half of the hair on my arms. I checked with my Mom and she said that all of her hair fell out during her chemo. Hmmm … I just found out that Taxotere, one of my chemo drugs, is the subject of a number of lawsuits for causing permanent hair loss. Oh good god. I hope that this is one of those baseless class action law suits. Now I have to worry about permanent hair loss. As if I wasn't worried enough about other stuff.

Overall, I’m doing pretty well at the halfway point. I’m back at work with my regular schedule. (I have taken three days off to get chemo and recover with each round.) I’m back at CrossFit. I’m losing a little strength and I become winded easier than before I found out I had cancer but I can still get through a workout. Miguel, one of my coaches, set me the goal of doing a handstand push-up before I finish chemo. I have two months. I am going to try like heck to do it. 

I have an upcoming appointment with my surgeon on January 5. She is going to check my progress. Hopefully she will agree that those tumors are shrinking!! Also, I am going to start to hear about my surgery options. She told me that a lumpectomy was out of the question. She said that she would not be able to save my nipple.  So I know that I am looking at a mastectomy of my right breast. But I do not know whether they will recommend a double mastectomy or whether they will recommend more extensive surgery. Ultimately, the decision will be mine. It’s a big decision. 

Pre-round three swim suit photo.

Genetic Testing

As part of my treatment game plan, my surgeon, Dr. Coleman, suggested that I be tested to see if I have any cancer gene mutations. This is important information for me to consider as I decide whether to have a double or single masectomy.

From the National Cancer Institute website: "BRCA1 and BRCA2 are human genes that produce tumor suppressor proteins. These proteins help repair damaged DNA and, therefore, play a role in ensuring the stability of the cell's genetic material. When either of these genes is mutated, or altered, such that its protein product either is not made or does not function correctly, DNA damage may not be repaired properly. As a result, cells are more likely to develop additional genetic alterations that can lead to cancer."

"A woman's lifetime risk of developing breast and/or ovarian cancer is greatly increased if she inherits a harmful mutation in BRCA1 or BRCA2."

I met with a genetic counselor in November who spent about an hour going through my family history and explaining the process to me. She calculated my risk for a mutation at the time as only 2.7%. A number of studies have shown, however, that triple negative breast cancer tumors are associated with BRCA1 carriers. Plus, my family had a "mother-daughter pairing" of breast cancer which is also a possible indication of a mutation. I decided to go ahead with the testing and I opted to have them test for all mutations. At this time, they are not sure what all mutations mean so I was warned that I may test positive for mutations and not have any guidance for me on how to plan a treatment around those types of mutations.

On December 14, I returned to the genetic counselor for the results. The meeting took five minutes. I have no mutations or variants in the genes that they tested. Yes!

"... No mutations or variants of unknown significance were detected. Due to limitations of the current testing, negative test results in a woman diagnosed with breast cancer must be interpreted within the context of her personal and family history. Genetic testing was appropriate for Ms. Hable, given her diagnosis of early-onset triple negative breast cancer and a mother-daughter pair with breast cancer. There is no family history of ovarian cancer, male breast cancer or multiple HBOC-related cancers in one individual, however.

"Ms. Hable's cancer might be more appropriately classified as 'familial', i.e. due to multifactorial causes, the presence of low penetrate genes or a clustering of sporadic occurrences."

" Implications for Family Members: ... Women who had both a mother and sister with breast cancer were 3.6 times as likely to develop breast cancer as women with no affected first degree relatives."

The Indignities of Cancer

My wonderful hairdresser thought I might feel better about shaving my head

if she did up my make-up and gave me fake eye lashes.

One day, right after I found out I had cancer, I was doing the Workout of the Day ("WOD") at my gym. This is before I started chemo and I was feeling fine. It was a long workout that involved wall balls. Wall balls are my nemesis as I rarely breathe properly and end up panting and feeling like my arms might fall off. (For those who might not know, "wall balls" are squatting below parallel and then standing up as you throw a weighted ball at a 10-foot target. The prescribed weight of the wall ball for women is usually 14 pounds.) And I remember thinking, screw it, I have cancer, I can just stop now and no one will question it. I had my moment and then picked up the ball and started getting the wall balls done. And I just repeated over and over, no one is going to feel sorry for you.

Fast forward to this week. I'm a week out from chemo and I'm slowly crawling out of the hell hole of it and starting to feel better. But my mouth hurts and my tongue has white bumps on it, and my throat hurts. And I'm so effing tired but I am determined to work my regular hours at my job. Seth had a dentist appointment on Tuesday so I had him ask the dentist if he could recommend any mouthwash or toothpaste that might help. The dentist ended up writing a prescription for me for some mouthwash. Being the cautious person that I am, I emailed my oncologist on Wednesday morning to make sure that this was OK with him. He usually responds within the hour but I didn't get a response until 4:50 pm. My doctor was out of the office so his partner emailed me. He said that he thought I had thrush (very common for chemo patients) and he had called in a prescription for me for that. I Googled it because I wasn't exactly sure what thrush is. It's a yeast infection in your mouth. GROSS! So, I left work at 5 and traffic was bad. It took me 30 minutes to get home and I live 2.7 miles from the office. And somewhere in those 30 minutes I lost it and started feeling sorry for myself. First I lose all my hair and feel ugly and now I have a yeast infection in my mouth. I'm not even mentioning the constipation/diarrhea/hemorrhoid extravaganza. Could I be any more disgusting?

I got home and ate peanut butter cups and drank ginger beer (non-alcoholic) and cried. FWIW, ginger beer is one of the few things I can still taste and that tastes good to me so I drink it a lot. It's all carbs. I'm sure I don't need the sugar but it's worth it just to taste something. The other day I had a donut and it tasted like cardboard. I threw it away after eating half of it. What's the point if you can't taste it? A DONUT!!!

I felt sorry for myself for the rest of the week. I ate french fries (with an obscene amount of salt) and cried a lot. 

And then on Saturday morning, I came to the revelation that I was feeling sorry for myself and that was no way to act. This is not how I want to act. This is not the person I want to be.

I got dressed and went to the 8 am CrossFit X-Diesel workout. As I had each day that I worked out, I wore a head scarf to cover up my bald head. But half way through this workout, I ripped it off and worked out with my bald head showing. It was a long workout with a 35-minute time cap. I was the last one done but I finished it. It felt good. I know that CrossFit seems like a cult or crazy to some people but it is something that really keeps me going. I find myself in those workouts. I find the person that I want to be in those workouts. And that person is not someone who feels sorry for herself (for very long).