Introducing... The Chemo Chronicles... Episode 1

Episode 1: Welcome to the Show!

AKA... Cylce 1: AC +/- bev

The particular chemotherapy cocktail I am on right now is called "AC-T," or "AC then T"...

Adriamycin (doxorubicin) and Cytoxan (cyclophosphamide) are the "AC." I have 4 rounds, or cycles, of this cocktail... through IV every three weeks. After the first 12 weeks, we switch to Taxol (paclitaxel or "T") for another 12 weeks... so a total of 8 cycles. This is what my oncologist calls the "Gold Standard" breast cancer chemo cocktail.

I am also participating in a double-blind, phase III clinical trial for a drug called bevacizumab (Avastin). I get this also through IV every three weeks for all 8 cycles.

Neither I nor my care team know whether I am getting the "bev" or the placebo, which is why it says "+/- bev" above. Barring any complicating medical factors, we'll all be "unblinded" around Labor Day. (My doctor can find out at any time it becomes necessary for my care.) The study has 3 "arms," creatively called A, B, and C. 20% Arm A, placebo group. 40% Arm B, real drug. 40% Arm C, real drug plus.... if I end up in Arm C, I will continue to get the bev every three weeks for an additional 10 cylcles (30 weeks). I'm actually kinda hoping for Arm C.

Monday was a long day with a haircut and a stop at Micheal's to look at yarn before the doctor. We were at the clinic from 12 noon to 5:40. After a quick sandwich at Subway, we got home around 7. I went straight to the couch and was in bed by 9.

I have to have blood drawn before every treatment and then see the doctor, so I'm there for an hour before my treatment even starts. Because it was my first treatment, the chemo drugs were run in a little slower so my treatment took 4 1/2 hours. The remaining AC cycles, I should only be there about 4 hours; being on the study adds time because the study drug has to go in too. The Taxol treatments are shorter (2 hours), but weekly, so kind of a trade-off.

On a funny side note: Adriamycin aka doxo-"rubi"-cin... rubi like ruby red is comically known as "The Red Devil," because of its ruby red color... it makes you pee orange... like cheetoh/tangerine-y kind of orange ...like immediately after it goes in and for the next day or so... kind of funny... the nurses tell you that right away, first thing as they are giving it...(it goes in as an "IV push" not an infusion, which means the nurse manually pushes it in slowly over about 15/20 minutes from a couple big honkin' syringes rather than hanging in a bag and dripping in) Good thing too because I had to pee as soon as she was done putting it in... totally orange!

Side Effects...

I'm not thrilled about losing my hair, but whatever... I'm hoping to lose my leg hair too. Not having to shave for the summer would be what I consider a "Perk." I'm on the hunt for big earrings and funky scarves, and my Mary Kay lady gave me some free eye shadows and purple eyeliner to play with, so bring it on! I am still anti-wig; they're itchy.

Honestly, I was mostly afraid of the nausea. I really, really, really hate throwing up. My doctor had told me that it would be ok, but I was still very skeptical and preparing myself for the Worst... "The Worst" being spending days languishing on the bathroom floor, worshipping the porcelain god.

Prior to the actual chemo drugs, I get a cocktail of IV anti-nausea meds. Emend first, then Zofran and dexamethasone together. These meds take about 30 minutes total to infuse. I also have presriptions for Emend and Compazine for the next couple days. Emend is wonderful stuff that you take once a day. Compazine is an "as needed" med. Even though the Zofran gave me quite a headache for about 24 hours.... AWESOME COMBINATION!

I did spend 3 days at a constant state of semi-queasy, but I Never Threw Up! for which I am profoundly grateful.

It was worse in the early mornings around the time my husband was getting up (I think it was because my stomach got empty overnight), so he would get me a piece of squishy-white-bread and I would pop a Compazine and that would get me through until I got the kids off to school. And then in the evenings it would get bad again, so some saltines and a Compazine and I was ok. Thank you Lord for minor miracles.

Other than that... I was just very, very tired... collapse-on-the-couch, can't-keep-my-eyes-open-but-can't-quite-sleep, watching-tv-is-a-lot-of-work, too-tired-to-crochet tired. I usually had a couple little energy bursts. Enough to get a shower or load the dishwasher... except Thursday... Thursday was the worst fatigue. But then I perked up quite a bit on Friday and I felt great onSaturday! Sunday was pretty good, just took it easy in the afternoon.

I am now in what is called the "nadir." It's the time when my white counts are at their lowest, usually between 7 and 10 days after treatment. They start to rebound by about day 14. By 21, they are supposed to be back to normal so we can start all over again. But this week, I have to be really careful because I am at high risk of infection. The nurse actually told me that if I have a fever over 101 or chills to call, day or night, because that may be the only sign I have that an infection is starting. I was never germ-a-phobic before, but I am now.

I have also decided that I am not going back to work right away as I had planned. I have up to 26 weeks of short term disability through work, and I'm going to use it. Both the clinic social worker and my oncology nurse said that these first 4 cycles are very physically demanding and since I have a physical job (not a "desk job"), they both heartily recommended not working if I don't have to. I'm supposed to "stay active," but it's not like I don't have "Life" to keep me active enough between home and church... besides, cancer has started to feel like a full time job all by itself.

By the time I run out of disability, I will be close to starting school. My doctors all say that I should still be able to go ahead with my school plans for the fall. So I am moving forward with that. I should have all my paperwork in this week and will find out by mid-June if I have a spot for sure. Classes start the end of August.

Through it all, God is good. My prayer blanket got a real workout this week. It was never far from me exept when I was close to My Honey. My husband is awesome! My kids really stepped up this week and helped out. I am so proud of Rob and the maturity he is starting to show. My friend helped out getting the older boys to school. My sister brought me strawberries from Cosco. My church family helped with meals and any other support needed. It's good to be so loved.