First Dose of Taxol (and Hair Pics)

I made it through the first half of chemo, 4 Adriamycin/Cytoxan cycles, so today I graduated to the T part of my A/C + T = NMC (no more cancer, but that's not a proper medical term) equation.

Most people find, I'm told, that the Taxol cycles are easier than A/C because they tend to have fewer side effects. For example, I will only have to take one of my anti-nausea drugs on the night before and morning of each treatment (instead of for 3 days after), the second one for 2 days after instead of 3, and the third one as needed (same as before, but I was "needing" them more regularly after the last treatment - A/C gets tougher as it goes on, and I'm glad to be shooting up another now poison instead). I'll still need the day-after Neulasta shot to keep my white counts up. The fatigue will continue to cycle downhill, with Monday - Wednesday being my most tired days. And I will probably experience temporary neuropathy, a form of nerve damage that causes numbness, tingling, or pain, primarily in the hands and feet. Most people find this to be fairly mild, but if I have trouble, say, putting on my earrings or walking, the doctor will change my drugs.

On the other hand, a lot of people have allergic reactions to T, so administering it is a slower, more cautious process. I arrived at the hospital at 9:30 for my appointment with Dr. Cohen (we talk about the drugs, any side effects, new prescriptions for those side effects, and he checks my scar tissue, and so on), got my vitals checked (blood pressure and body temperature nice and low, weight holding steady), stopped in to Dr. Cohen's assistant's office to make my next appointment (she's very friendly and thorough, and also has a busily ringing phone to answer, so this is always the longest of my pre-infusion steps - one of the infusion nurses actually hunted me down this morning, saying it was the longest appointment break she'd seen). By 10:45 I hit infusion, got Marie-Anne again, and they took my blood for the CBC and the study I'm participating in (my counts have been good, but platelets are still high, so we anticipate a blood marrow biopsy in the not-too-distant future). Then I hung out for a while until the lab said I was a go. Then they ordered my drugs. For Taxol cycles, I get pre-hydration, Zofran for nausea (no double vision this time!), and Benadryl and Pepcid to combat possible allergic reactions.

I finally started the Taxol at 12 noon. They started the drip really slow, then turned it up every 10 minutes as I showed no signs of allergy - no back or shoulder pain, itchy throat, tight chest, trouble breathing, nausea, etc. Unfortunately, the patient two chairs down wasn't doing as well with her first T treatment. I was glad they pulled the curtain. The drip took 3 1/2 hours, then I got some more hydration, then a flush to rinse my port, then the Heparin to keep the port from clogging. I was done at 4 PM, about 2 1/2 hours later than the A/C cycles. It's a long time to sit, literally tethered, in a hospital chair, even with the Thursday crossword puzzle. But no negative reactions to the drugs, so that was good, and they can speed it up a bit in two weeks.

A few other notes:

Shaving my head - I think most folks heard that I did this while Dave's parents were here after my second treatment. When I read my hands through my hair that morning, a lot came out (it doesn't hurt at all, not like someone pulling healthy hair, since the follicles are dead), so I decided that was it. We all took turns with the clippers (well, not Finn) and it was a grand time. Then this past weekend, we actually shaved off the rest of the stubble with a razor (it was looking pretty patchy by then) so I'm a true baldy now. I suffered a few nicks, and the job wasn't as clean as I wanted, though David wielded the razor valiantly. Fortunately, Erin and her boyfriend (now fiance!) visited from Chicago that afternoon, and Jason, a practicer of the bare-headed look, offered some great tips about equipment and product, including a little razor car that I can drive over my head, shine-eliminator (no hair to absorb the oil, so it builds up on the scalp), and so forth. He also gave a dramatic lecture about the necessity of sunscreen. Believe it. And wear it. I actually like the bald look and think I might go out like this sometimes - with big earrings and a lot of lipstick. I have been wearing more make-up than I used to because my wig is so much more "done" than my real hair usually was that I felt like my unadorned face wasn't quite living up to it! Another weird wig thing that I haven't figured out yet is how to wear my sunglasses. The little sideburn notches totally get in the way. The "earflaps" stick out a little bit if I try to tuck the glasses underneath them, not odd-looking to others, perhaps, but definitely noticeable to me. And the glasses feel tight if I try to put them over that hair, and that looks strange, too. Stay tuned for how I solve this dramatic cancer-related issue. Perhaps more hats are in my future.

Breast MRI - The American Cancer Society advised recently that women at greater risk for breast cancer should have MRIs instead of mammograms. An MRI is a more sensitive test, and a more expensive one, so it picks up a lot of false positives and results in a lot more biopsies than the traditional mammogram; therefore, it isn't suggested for all women. The recommendation was announced the day after I asked Dr. Cohen if I needed an MRI and he said no. But after reading the article, I pressured him for an MRI on both breasts, just to be sure, and though he still didn't think I needed one, he wrote the prescription. I thought that I would feel more comfortable with these more complete results, since my mammogram report noted that my much of my breast tissue is dense and growths could be missed in those areas. Anyway, my MRI results came back CLEAN AS A WHISTLE - no signs anywhere of additional cancer or precancerous cells, not even around the area the surgeon excised. So that was great news! (But please, girls, I hope you're getting your mammograms - don't skip them!)

Brain MRI - Don't freak out, but Dr. Cohen also suggested that I have a brain and cervical spine MRI because I've been feeling some stubborn tingling in my cheeks, and sometimes in my arms, for the past few weeks. The feeling began a few hours after my third treatment, with some numbness and tingling in my cheeks. Within a few hours, it spread to my forearms, where there was an accompanying pressure, like a blood pressure cuff feeling. Later that night, the same pressure and tingling was in my calves. I was still able to move normally, no swelling, loss of mobility or sensation in my skin, and it was all gone by the morning. Dr. Cohen wasn't too concerned. The same symptoms and timing repeated after my fourth treatment, again disappearing by morning. But when the tingling reappeared in my cheeks early this week, I started feeling nervous. The intensity changes, but the tingling has been fairly constant over the last few days. Sometimes I feel it in my arms, though not recently in my legs. What's causing this? Neuropathy is NOT a typical side effect of the drugs I'd been taking before today. Dr. Cohen very gently suggested anxiety. I heartily disagreed, but he prescribed Xanax. I know that anxiety increases the intensity of the feeling (I got myself so worked up about it on Wednesday that my hands were shaking as I tried to feed Finn), but it seems too coincidental that the symptoms arose within hours after my third and fourth infusions. So he also prescribed Pepcid, an antacid that also moderates some allergic reactions. So maybe those things will help. But nonetheless, my good doctor can't ignore such a strange and persistent symptom, so off I go for a brain and neck MRI on June 5, to eliminate any possibility of neurological damage (or such damage that would cause cheek tingling, anyway).

Exciting bit of news: Dr. Cohen gave the thumbs up for a little vacation in between chemo and radiation. So while I still won't be able to make the big family trip to Michigan in August, we're planning a late-July outing to Cedar Point. (Actually, Dr. Cohen was like, "Amusement park, huh? Not the most germ-free of vacation environments..." I promised to wash my hands a lot and not eat much on the Midway.) Some of you might not know that I am an absolute rollercoaster freak and that Sappha is my exactly 54" tall rollercoaster freak-in-training. So we are way pumped. (Dave is not as wild about the scream machines, so he can push the stroller. Just kidding. Sort of.) It will be a really nice break for all of us before I start radiation the following week.