Thin

Wigged Out

There’s only a ‘wafer thin’ layer of hair remaining on my head. My scalp is strangely tender … the feeling that you have when you’ve had something pulling on your hair for a long time and then it is released. I believe that it’s the tell tale sign for impending baldness. So this week I decided that I need to get serious about wigs. 

I’m taking the most positive approach I can muster towards my “chemotherapy induced alopecia”. First of all, it’s the only side effect that doesn’t cause me a great deal of physical discomfort so I’m thankful for that! And while in the spirit of glass half full, I’ve decided that baldness provides an opportunity for me to explore different looks, have some fun! Freak people out! 

I have learned that in the wig world there are essentially 3 choices: synthetic wig, human hair wigs and wigs that are a combo of the two. 

Synthetic Wig 

The synthetic wig is reminiscent of Barbie hair. This is generally not a great feature in my opinion, as I found Barbie hair to be infuriating to deal with as a child. Think static, tangles, difficult to brush. However, synthetic wigs are permanently styled so you don’t have to fuss with straightening / curling etc – you just give the wig a generous shake, pop it on your head and you’re good to go. (Just remember not to stick your head near the woodstove or oven. It will melt.) The decent ones start at about $250.00

Human Hair Wig

The human hair wig is better made and looks (obviously) more natural. You can get them made to match your exact style and colour. However, human hair wigs need to be styled and washed just like human hair – regularly. Looks better, but involves WAY more maintenance. What sealed the deal for me is that they start at over $1000.00 each. Since I need to feed my children, it’s really not an option. Plus I’m lazy in the hair styling department. Let’s be honest. 

The Results of my Shopping Expedition

I headed to see Bridget at “My Left Breast” and began trying on wigs. (I had learned quite a few important guidelines to follow for putting on and taking off wigs at a seminar, so I felt prepared. Believe me, it’s more complicated than it seems… where to hold it, how to adjust it, how to take it off with minimal damage.)

It didn’t take me very long at all to narrow down the choices. Here’s one of the winners. I love the colour – matches my glasses. 

Sophia wig
Chestnut?

This second one is just so close to my (most recent) hair colour that I couldn’t resist. It won’t freak people out when they see me. They may not even know I have a wig on. (If my eyebrows last…). 

Wig like me
Pretty sweet!

As you likely know, wigs can be pretty hot and itchy – so the thought of adding a hat or scarf OVER a wig is not very appealing to wig wearers. And I LOVE hats! Well there IS a solution! There are wigs that are specially designed to be worn under hats – they don’t have anything on the top (other than straps)?? Oh yes!

This long haired wig fit the bill for me … I think it’s hilarious! I can braid it or put it in a ponytail. It’s my undercover hair. No one will know it’s me out on the paddle board…

Long hair
I’m channeling my inner Joni Mitchell.

My Homemade Wig

Finally, I made up my own “real hair wig”! I retrieved the braids that I chopped off 6 weeks ago and grabbed some supplies: pins, thread, glue gun, beanie and a 5 cm strip off of the bottom of one of Liam’s T-shirts (shhhh). I did some sewing to create a band that would fit exactly into the beanie, pinned it, revved up the hot glue, and went for it!

Here’s the process! 

My hair!! So pretty.
Process
Made a band from a T-shirt, pinned it in to the hat, stuck that hair in the right spots. Glued the sucker.
Finished product
Beanies are not flattering – but they fit nicely under hats!

I think I’m all set! 

Choices

Next up, wraps, turbans and do-rags … 

 

33.3% Done, 100% Learning

Yesterday I had my 4th treatment of 12. So ya, I’m 33.3% percent done chemo! During my obligatory insomnia after treatment, I’ve began reflecting on “what’s been my learning”. SO MUCH LEARNING! 

Chemo Patients are not Judgy

Right from the get go I started talking to other patients in the suite. Some patients have headphones in, have their head down, are napping or texting or reading. But others make eye contact, smile, give knowing glances when something happens in the suite (new patient, volunteer with cookies, joke being cracked). These patients are the sharers, the helpers, the commiserators. I like these people!! (Please don’t get me wrong, chemo sucks and it’s ok to have your head down and get through it … I don’t judge!!)

Yesterday was a long chemo for me – 3 1/2 hours – since I was also getting Herceptin (I get this every 4th treatment). So there was quite the ebb and flow of patients in my section (many have 1 hour treatments). I was in the first “bay” where there are two nurse sections. I’ll draw it for you:

drawing of chemo section
This was my first week in this area. I liked it because it’s more cozy. The other section shares the long back wall & more chairs (beige too), so it’s more spread out.

At one point there were a total of four ladies having their chemo – all in the second category of people… the eye contact people. I noticed that the lady across from me had no eyelashes and eyebrows but a full head of hair. To her right the knitter had soft fluff growing in on her head. To my left the lady’s hair was obviously thinning. So I started up an alopecia conversation. It was AWESOME to hear their stories and advice!

It’s not like being new mother where everyone weighs in on breastfeeding and circumcision and family beds and pretty much EVERYTHING where there is a choice to be had! These women were smiling and nodding and laughing. Not judgy. It was so refreshing.  

 

Make Friends with Digestive Cookies

They’re all you’ve got when you forget a snack.

I need to investigate into this choice of chemo cookie. 

digestive cookie

Seeing Friends at Chemo can be Heartbreaking

On my first day in chairs at the Cancer Centre when I was waiting to see my Onc, I heard a voice I knew. I looked over and recognized a friend and former neighbour. I babysat her kids for years. I loved her boys, her house, her husband’s twinkle in his eye and generous laugh, her huge smile and loving heart, her trust in me. I was immediately sad and happy to see her. She is now obviously a patient. Thinner. But in no way diminished. I waited for her to stop chatting with the lady who was sitting 2 seats over. When I called her name, she looked at me, paused and gave me that look. Oh! Oh. And we talked. 

Yesterday a former Teacher Candidate walked through the suite with his mom while I was chatting with my sister. He heard my voice, looked over and came to give a hug. I think I gave him the look. Oh! Oh. And we talked. 

It is far too easy to lose touch with people that you value and love. I will strive to do more reconnecting and less disconnecting. Meeting people in the cancer clinic who you love but have become disconnected from? It’s bad ju ju.  

 

Silver Linings Exist

On my 2nd treatment day I met Kari who came in with her dad and mom. Her dad was having his first chemo. He was in the chair to my left. It was stressful and hard for them all. We chatted, commiserated, I tried to support, we shared information. Now we text every once in a while and check in on each other’s lives as we live with cancer.

Sparks of light connect in strange places. And I’m grateful for it. 

 

Noticing Matters

I can’t even tell you how many notes, swearing socks, dinner contributions, emails, gift cards, brown chair texts, books, comments on the blog, chocolate, spa treatments, hugs, visits, jewelry, prayer, tea, etc etc etc x100 that I’ve received from family, friends, colleagues, students, former students … the list is overwhelming to me.

tea
At this point I appear to have all the tea in China.

One of the things that have surprised me have been the bits of support that are related to my treatment. We all know that side effects suck. So when I get tips that help me, I REALLY appreciate it! Here are some examples:

  • Adrienne told me about Secaris which is a clear gel that I stick up my nose to ease the sinus pain. (Better than the Vaseline purchased 10 years ago!)
  • Jim told me about chewable Papaya enzyme (who knew??) and Natalie sent me Digize which is an essential oil that I put it in my vaporizer or rub a diluted mixture on my chest – both ease heartburn.
  • I got stool softener advice from the lady with thinning hair! It works!! omg and that was yesterday! TMI 
  • Wig advice from Jane and Jenn (who I don’t know but a friend hooked me up with her via email).  
  • My cousin Cheri who is a prof at U of Windsor and is currently researching the benefits of exercise for breast cancer patients sends me pertinent research journals (from Current Ocology – A Canadian Cancer Research Journal). There are exercise guidelines in there that I am thinking about trying to follow. Sorry Cheri. WIP.
  • Cheri’s colleague Lisa whose research of the benefits of yoga. I’m doing better with that one. Thank god for Yoga with Adriene
  • A local doc friend got me onto reading Research Monographs for the drugs I’m taking. Fascinating and helpful. (I like data.) 

It’s ALL important. It doesn’t matter what it is … big gesture or small gesture … doesn’t matter. It’s primarily the noticing and the encouraging. The medical stuff is like icing on the cake.

Note: I apologize to all of those people in my life who I didn’t pay enough attention to when they were going through HELL. I think that I felt far away and unknowing and unhelpful and not wanting to say the wrong thing. BUT THAT WAS STUPID. STUPID!!!!! So if someone in your life is going through something – let them know that you are in also in the universe, thinking about them. That’s all. (Sorry Jayne. Sorry Jane. Sorry Sherri. Sorry Jim. Sorry Kirk. Sorry Marilyn. I love you. Please forgive me.)

And so…

Bottom line is that I’m learning. This learning journey is hard, but important, as all journeys are. Thanks for walking it with me. Thanks for teaching. Thanks for helping. 

blogging

Games

Up for a game? It’s word association game. Easy and fun. (Mostly for me, but whatever…) Ok, so I’m going to say a word, you’re going to say a word. Easy. Trick is, you have to hold it in your head. And when you’re done reading, post it in the comments. K? Thx. (Maybe get a piece of paper right now. lol)

Are you ready?

First word. CHEMO. (Hold it in your head / write it down … whatever you have to do … but you can’t change your word, ok? Can’t.)

Thumbs up
Way to go!

Note: I’m playing this game with you because I watched an interesting interview the other day. The interviewer was asking 4 sets of twins questions about themselves – including how they think. She played this game with each set and it was rather amazing how many they answered the same. It got me thinking about how people think about chemo. 

The Game I’m Playing

This post is going to explore the game of getting this chemo thing right – the balance between managing side effects well and not managing them well. The getting it right. The trial and error. The game. 

Why? I’ll tell you. Yesterday I had my 3rd treatment. (Yup, I’m 1/4th done the chemo! WOOT WOOT!) The day before, in my obligatory pre-treatment meeting, I talked to my Onc (that’s short for Oncologist) about cutting back on some of my pre-meds. Why? Because I think I’m smarter than her?? NOOOOOOO. Because I’M A PERSON THAT DOESN’T LIKE TO TAKE DRUGS. I perseverate about taking an Advil, for Christ’s sake!!

You might wonder … why don’t you just do what they say? Take the drugs? Answer:

  1. I want to be an active participant in my health care.
  2. I want to maximize the good effect of the drugs while minimizing the negative. 
  3. I don’t want to suffer unnecessarily.

How do I Play this Game?

I have to know what the drugs do, then analyze the effects they are having on me, and then see if I can tweak it. I talked about these drugs a bit in a previous post, my apologies. But now I need to say more about them. Here’s my current analysis:

Drug #1 – Paclitaxel (chemotherapy)

  • common name: Taxol
  • purpose: effectively kills breast cancer cells 
  • visuals: clear fluid in a drip bag that comes out of a special door and is checked twice by nurses and once by me
  • dosage: determined by my weight and height – I have ZERO CONTROL over this dosage and treatment plan
  • repeats: 12 (once / week for 12 weeks)
  • what it does to me:
    • triggers the puke response in my brain which to get it the hell out of my body (so far this has resulted in a very sore gut, as I’m not a puker)
    • goes to all fast growing cells and KILLS THEM – cancer, lining of stomach, hair, lining of esophagus, skin, lining of mouth, lining of nasal passages, toenails and fingernails, eyelashes, eyebrows, pubic hair, leg hair (ok you get the idea)
    • heartburn
    • nasal cavity pain
  • positive side effects (aka silver lining): smooth skin, lots of time for reflection, meet new people, look at life differently, increased respect for modern medicine, weight loss (ok, this is hypothetical – it has not happened)
  • worst thing: side effects are cumulative – the drug is not fully eliminated each week – I will feel worse and worse
  • word to best describe it: toxic

Paclitaxel

Drug #2 – Diphenhydramine (“pre-med”)

  • common name: Benedryl
  • purpose: prevents allergic reaction to the solvent that is in the chemo (I know, right?)
  • visuals: long thin hot pink capsule (taken orally just before chemo)
  • dosage: 50 mg (2 pills)
  • repeats: every time I have chemo (12 weeks)
  • what it does to me: can’t talk properly, wobbly, incredibly sleepy, needed an assist to the washroom
  • postive side effects: basically stoned
  • my response: cut it back to 25 mg on Treatment 2
  • result: better 
  • word to best describe it: loopy

pink pill

Drug #3 – Ondansetron (“pre-med”)

  • common name: Zofran
  • purpose: prevents nausea & vomiting by blocking seratonin (which causes vomiting)
  • visuals: oval beige pill (taken orally just before chemo – and I have to remember to bring it)
  • dosage: 16 mg (2 pills)
  • repeats: every time I have chemo (12 weeks)
  • what it does to me: causes me to not have a shit for at least 3 days after taking it and then it’s HELL, PURE HELL 
  • my response: cut it back to 8 mg on Treatment 3 
  • result: earlier gut pain, face is a bit tingly (remember it? … that slightly queasy feeling?), too early to tell you about poops but you can check in with Annie at any time, as I send her poop emojis 
  • word to best describe it: questionable 

ondanestron

Drug #4 – Ranitidine (“pre-med”)

  • common name: Zantac
  • purpose: prevents heartburn by decreasing the amount of acid that the stomach makes  
  • visuals: clear fluid in a drip bag (I got more OTC – over the counter – as well as a stronger one with a script)
  • dosage: no idea
  • repeats: every chemo 
  • what it does to me: mild headache (not sure it’s from this particular drug, but it’s the first side effect listed)
  • my response: enjoy it while it lasts (about 36 hours)
  • result: watch my diet closely 
  • word to best describe it: awesome
zantac
This one I NEED, I know it works, and it doesn’t seem give me other bigger problems.

 

Drug #5 – Dexamethasone (“pre-med”)

  • common name: Decadron 
  • what it really is: corticosteroid 
  • purpose: fights nausea, hypersensitivity
  • visuals: clear fluid in drip bag
  • dosage: 20 mg
  • repeats: every chemo 
  • what it does to me: sleeplessness, hyper in first 48 hours, water retention, stimulates the appetite 
  • what studies say it does: early pre-trial studies demonstrate that Dex is contraindicated for Paclitaxel! WHAAATTTT? This means that the more steroid, the less the Taxol works. So this is a big problem for me!!!! I’m going through this and the Dex is making it less likely to work??? 
  • my response: reduce the steroid as much as possible!
  • result: cut it back by 1/2 to 10 mg on Treatment 3
  • word to best describe it: danger
dex problem
My onc rolled her eyes when I asked her about pre-trial studies that indicate that too much steroid reduces the effectiveness of the Paclitaxel. WHAT?? AN EYE ROLL?? But then she said she’d reduce it by half. HUH?? Maybe she doesn’t like it when patients ask questions and want to take control of their own health. 

Conclusions:

  1. It’s a game of measures. How can I get the greatest effect of the Paclitaxel (chemo) with the least amount of suffering?
  2. It’s challenging, this constant self care!!! 
  3. I bet most chemo patients don’t know half of this shit.
  4. Oncs are human. They get annoyed by patients with questions and demands. (Do I do that with parents who push back?? Do I roll my eyes?? Jesus God I hope not.)

Your final task:

Now that you know more about the game of measures, I’m going to give you another word, and you have to say the first word that comes to mind. Ready? (and yes, that means you’ll have two words…)

CANCER

 Now post your two words! Thx for playing! 

vaseline

Thin Skin Begins

In an earlier post I mentioned how the killing off of cells in the esophagus and stomach can result in heartburn. Turns out that there are more cells in the gastrointestinal tract that are affected. I’m sure you’ve heard of the mucous membrane. It lines all body passages that communicate with the air, such as the respiratory tract, and have cells and glands that secrete mucus. Makes sense.

When you have chemo, the mucous membrane is affected. Bad things happen. Smart people call it mucositis. 

 

mucositis

The part of this lining that covers the mouth (oral mucosa, go figure), is one of the most sensitive parts of the body and is particularly vulnerable to chemotherapy. You don’t want oral mucositis. Open sores, bleeding gums, pain, pain, discomfort, hard to eat, yuck. So I’ve decided to pass on that side effect. 

An ounce of prevention … 

I’m doing some simple things, like:

  • changing to a soft toothbrush
  • using a less harsh toothpaste 
  • swishing twice / day with flat soda water (you can also use baking soda and water, but YUCK!!)
  • avoiding foods that would irritate the mouth (spicy, acidic, you know all about it…)

I’m also doing something called “oil pulling”. It’s an Ayurvedic practice that is simple and boasts very positive results for oral hygiene. I’ve been doing it since Christmas when my big brother told me about it – and I have already noticed a difference in how my teeth feel. 

How to oil pull: put up to 1 tablespoon of an oil such as sesame, sunflower or coconut in to your mouth (ok, I use about 1 teaspoon) and actively swish it / pull it through your teeth for 20 minutes. No swallowing! Then you spit it out (not in the sink or toilet as it will harden) and rinse with warm water, spit that out (not in sink or toilet), and then brush and floss (gently in my case). I use coconut oil because it also has lauric acid in it, which is apparently very good. Plus it tastes better (not that you taste it, to be honest, but I imagine that it tastes better). 

coconut
I am too lazy to warm it up in the morning so I take a teaspoon of it in its solid state and chew it / let it melt in my mouth. Kinda gaggy, but you get over it. Or you can not be lazy and warm it up.

At first I could only do 5 minutes. But I worked up a few minutes each day and now I have no problem with 20 minutes each morning. And it’s amazing how much I can get done while I’m swishing … light the furnace, chop some wood, make the bed, … 

So far my gums are healthy and I have no indications of any sores developing. I’m sticking with it! 

Sniffle

My nose, however, is starting to suffer. The skin cells are not reproducing any more, the hairs that normally trap the mucous are disappearing, and the membranes are thinning. This results in:

  • dry, crusty nose – feels like there are scabs in there ALL THE TIME
  • bloody bits and smears and chunks in the mucous coming out of my nose (I have a photo, but it’s just too gross)
  • sniffling 
  • did I mention that it feels really dry? 

So I’m working at increasing the humidity in the house – water on the woodstove, vaporisor by my bed. And I LIBERALLY coat the inside of my nose with Vaseline. 

vaseline
Where did this even come from? Kroger mystery. Is there a shelf life on Vaseline? So many questions. 

Apparently, if my nose does start to bleed, it may take a while to stop, since my platelets are affected by chemo. So NO NOSE PICKING! 

Butt wait, there’s more!

On a related note, remember how I was talking about how toxic I am?  The other day I search the Drug Monograph for Paclitaxel in order to see if there are contraindications for the use of essential oils and medical marijuana (that’s for another post, so sorry). There is a section called “elimination” that breaks down exactly how the Paclitaxel is getting out of my body. It says that there are “high concentrations found in bile; 71% excreted in feces in 120 hours”. OK NO WONDER MY ASS WAS ON FIRE!! 

elimination
This drug monograph is 14 pages long. Very informative.

And so you can understand why this mug is my companion, and why I send poop emojis to Annie so that she can be updated. (She loves it. Really.) 

poop mug and me
Sometimes there are fireworks.

Meanwhile, my head is feeling a bit numb / tingly. I think my next post will be about alopecia. Just a guess.

saltine

Heartburn Doth Strike

Heartburn appeared pretty much as soon as the cocktail of “pre-meds” wore off (one of which was a dose of Zantac). I felt really good on treatment day (apart from being high as a kite from the Benedryl), and the next day too. Then after a fab dinner of chili, Liam and I went to his Grade 9 Open House where I proceeded to SUFFER. 

As a consequence I am now armed with heartburn information and meds. Here are the highlights:

What is heartburn?

It’s often called Acid Reflux. Basically it’s when acid from your stomach that is there to digest your food goes starts to hurt you. Generally speaking, the acid in your stomach splashes up into your esophagus (food tube). There might be too much of it, your stomach might be too full or the muscle that acts as an elastic band between the stomach and esophagus might be too weak.

The official name for it is GERD (Gastroesophageal reflux disease) which is a disease that affects the muscle I was talking about. The official name is the Lower Esophageal Sphincter (there is more than one, sphincter! Ha!). As I mentioned, the LES is between the stomach and esophagus – it’s a band of muscle. GERD can also happen to pregnant women since the LES is more relaxed due to all of the hormones. Also, the baby pushes up against the stomach which drives food up through the LES. (I ate a lot of Tums.) Other folks who have a hiatal hernia can get GERD. That’s where part of the stomach and esophagus get pushed up into the chest wall where it doesn’t belong. 

Here’s a diagram that I drew for you (including my recent incisions and my portacath too). It  shows you where things are:

heartburn
Should have put the diaphragm in. Forgot that. 

Why does heartburn affect people on chemo? 

Chemo targets cells that divide at a really fast rate because that’s what cancer cells do, they multiply and take over and wreak havoc in the body. So any other cells in my body that also rapidly divide will be KILLED by the chemo. And the cells in the lining of my stomach and esophagus, which protect my digestive organs from acidic stomach acid are in the list of fast growing cells.

So basically, during chemo any stomach acid in my digestive system is going to hurt me because the protective coating (cells) are being killed off. I don’t have GERD per se, but during chemo I will have the same symptoms as GERD. Make sense?

What can I take for heartburn?

This is interesting! There are 4 different ways to go:

  • Tums, Rolaids: These are acid neutralizers that contain calcium and act as a buffer between you and the acid – but they can actually cause more acid to be produced once the barrier is gone (called acid rebound). Use occasionally. 
  • Gavisgon: This contains alginates (derived from algae) that also act as a barrier (coats the stomach). Very cool. Makes a “raft” and prevents the acid from getting up and out of the stomach. I think I will try the raft. 
  • Zantac: H2 receptor blockers (such as ratinidine) that reduces the amount of acid from building up but increase the risk of cardiovascular problems and osteoporosis – GAH! And I bought this! 
  • Nexium, Prevacid: Getting stronger now – prescription strength! These are “Proton Pump Inhibitors” that also prevent acid from forming – they seem to be like Zantac but are stronger, and not for occasional heartburn. These are for people who suffer badly from GERD and their esophagus is getting damaged. Lots of side effects. Avoid avoid! 

What can I do to avoid heartburn? 

Being a person who likes to avoid taking drugs, I am aiming to prevent heartburn rather than having to take the medications listed above. (Of course I WILL take it if I have to – I’m not into any extra suffering at this point!)

Prevention tips 1 and 2:

  • eat smaller amounts at a time
  • eat more regularly (this is a LOT harder than it seems)

Most importantly though, I have to stop ingesting:

  • caffeinated tea and dark chocolate – ok, anything with caffeine
  • wine / alcohol
  • oily / fatty foods (don’t even talk to me about this category, I can barely manage the first two)
  • citrus
  • tomato based foods
  • spicy foods
  • garlic & onion
  • more good stuff
  • more good stuff 
  • more good stuff

Basically, I’m going to eat BLAND food, very regularly, with lots of water. Oh boy. 

What is the silver lining? 

Let’s just be clear. When people mention the “silver lining” to a shitty situation, it’s akin to saying “there are plenty of fish in the sea”. Just shut up already. But if I had to pick the silver lining for this one, it’s 

Ok I can’t think of one. 

 

toxic logo

Toxic

Chemotherapy medicines are toxic. So therefore, when you’re receiving chemotherapy, anything that leaves your body is toxic. You have to be careful where it goes and who comes in contact with it.  

Naturally there are some basic safeguards – some that make tons of sense, some that are perhaps a bit surprising. Here’s the basic list:

1. Pee

You may not think that this is a big deal. Just flush it down and Bob’s your uncle (I know, he IS!). There are actually rules to the flushing. First one is to sit. Not a problem for me, as I always do. But dudes have to sit to pee. Not that that has anything to do with me, but I tought it was notable. Secondly, put the lid down before you flush. Who does that? Last, and the most disturbing to me, double flush! 

Flush sign

This may not seem upsetting to anyone … but I’m an environmentalist. Having grown up at a cottage, I’m already conditioned to NOT flush unless it’s very very yellow & stinky or brown. (Note: At home I do flush after I pee (promise), but I flush once.) So I find this to go against my principles. (I can tell you this, though, if I’m peeing during the time that I am receiving treatment at the cancer suite, you can bet I’ll be flushing twice! People track you with their eyes and likely listen for the double flush.)

The other thing about pee is that when you’re female of a certain age, it tends to be less able to stay in it’s correct location when coughing or sneezing or laughing or jumping on the trampoline.

I have been told that each time any pee gets on me I have to wash thoroughly (probably twice since that seems to be the norm) and if it gets on my clothing or sheets I have to wash them TWICE. Separate from other items. Geez. This seems like a lot of work. (Am I going to be wearing Depends?)

2. Sweat

I told the nurse that I don’t sweat. She raised her eyebrows as if to say “reeeeaally” or “you don’t sweat YET”. She then asked about hot flashes and night sweats. Hmm, well, I don’t sweat much …. ok, I’ll wash my sheets more often. Fine.  (But I’m not washing them twice.)

3. Vomit

I’m hoping I don’t have any issues in this department, but if I do, I have to follow the same rules as above – two flushes two washes. Of anything it touches. (I think I’m in denial on this one, but I’m not a puker.)

4. Stool

Who says stool?? It’s POOP, people!! I don’t think this will be a problem at all, since I haven’t generated very much since my 1st treatment. I know. It’s not a good thing. I’m on it …

poop inducers
Pear juice, herbal tea, bran muffins and a supportive mug. Bam!

5. Vaginal Fluid

Hold the bus. What? Yep – it’s toxic. So sex must involve covering it all up. Uh huh. A condom… and for other activities enjoyed by women, a dental dam. Ya, that’s not happening. 

What’s not on the list:

I asked the nurse why saliva is not on the list. I am going to try to reiterate what she said, but it didn’t make any sense to me so I’m not going to sound convincing. It’s ok because it is less likely to come in contact with someone. Um … what if I cough? Not enough. Or spit on someone? Funny look. What about kissing? Not enough. (Ok that woman must be a dry kisser.) I let it go. 

Some of the Additional Rules:

  • Anyone who deals with my “body fluids” has to (obviously wash it off their body asap, twice?), wear gloves and be given a medal. 
  • Any “body fluids” needing to be cleaned up are collected with paper towel that is then sealed in a plastic bag and put in the garbage – which is then sealed. (Of course I’m wondering what will happen if I toss it in the fire instead …)
  • If any of my “body fluids” get into my eyes or someone else’s eyes (ok … what??), the eyes must be flushed 2 or 3 times. Hard to get that image out of my mind. Projectile vomit? 

Good times, people, good times. 

And yes, you can visit me. Just stand back a safe distance. I’m toxic.

Waiting room

In the Brown Recliner

Prior to this cancer journey I didn’t pay any mind to the recliner chair. I began to see the light a few days back when I had my information session with a Cancer Centre nurse. Her job was to be sure I understood about the chemotherapy, the side effects, and the procedures at the Centre, but she actually helped me to understand the power of the recliner. Specifically the brown recliner.  

What I found out:

– The name of the place that I get my chemo is called “the suite”.
– The chairs for patients are all recliners.
– The brown chairs have a massage feature in them.
– It is chilly in the suite. Blankets are recommended.
– The brown chairs heat up. 
– There are less brown chairs than beige chairs.
– Wednesdays are the busiest days (this has to do with Tuesdays being the days that most of the oncologists meet with patients – which happens the day before treatment)
– Since I go on Wednesdays I may not get a brown chair.
– People can bring me food and drinks but they can’t eat or drink with me.
– TVs are all on mute. I must be able to read the closed captioning.
– There is one chair beside every beige and brown recliner … I can only have one visitor who is not eating or drinking.
– The washrooms in the suite are not for visitors.
– I cannot go to Tim Horton’s but I can go and pee with my IV pole. But not with my visitor. 

What I noticed on my tour:

– There are 4 sections in the suite, each one assigned to a different nurse. 
– Each section has 4 or 5 recliners. A couple of them are brown.
– There were only 6 patients in the suite, scattered in the different sections. All of them were in brown recliners. None of them were talking.
– As I walked through, each of the patients glanced at me with a knowing look.
– Chemo drip bags come through a hermetically sealed window at the far end of the suite. 
– There are 2 washrooms. (For patients.)

What I determined:

No picnics. No singing. No visits from loud friends. No way I’m missing out on a brown recliner. 

Brown chair
Coveted.

My first treatment is happening while I write this. And yes, I got here early, in hopes of a brown chair. Oh ya, you guessed it … I got one! 

Me in the chair.
Very comfy indeed.

My bum is nice and warm.  

What I’m Doing in the Chair Today:

Schedule for the today (week 1):

– begin with a “loading dose” of Herceptin (8ml / kg) that lasts 90 minutes (the next doses are not as big … they are called maintenance doses with 6ml/kg)
– They watch me for 1 hour. For side effects, but likely also to see what kind of patient I am … complainer? Rule breaker? Under prepared? No friends? Chatterbox? Eavesdropper?
– Then I get approx 1 hour of “pre-meds” before the taxol. They include 4 things:
1. Oral dose of anti-nausea pills that I have to remember to bring with me each week. Oh oh. 
2. Benadryl (oral)
3. 15 min of Zantac drip (coats the stomach, helps with nausea)
4. 15 min Dexamethadrone drip (steroid)
– FinallyI get the nasty stuff, Taxel for 1 hour and 15 min.
– Then I get a ride home at around 2.

My drip
Very impressive system!

Extra Curriculars:

I’ve got a load of things to keep me amused. All the technology: iPhone, iPod, ipad (yes, Apple junkie). Lunch & drinks. Knitting. Journal. Book & magazine. Etchasketch. 

Better get busy! Lots to do. 

 

 

Portacath

Port Me

Tomorrow I am going to have my toxic drug portal installed. It will deliver all of the nasty chemicals to my cells without any fuss or muss or burning skin. Ahh. How nice! It’s called a portacath, meaning a portable catheter. It’s made up of two parts: a small disk (port) and a long tube (catheter). Hence the name. 

Port-a-cath

Where does it go?

It will be inserted in my chest, just under the clavicle. Each time I go for a treatment – whether it be for the 12 doses of Paclitaxel (chemotherapy) in the first 12 weeks or the Herceptin (the targeted therapy) in the remainder of the year (18 doses) – the drugs will be delivered through the portacath. Nurses can also take blood through the portacath, even though my veins are quite charming and easy to take blood from. 

Giving blood
I think the nurse had performance anxiety. I can’t recall ever having had a drop of blood spill – or it hurting. Serves me right for taking a picture. 

How is it put in?

Usually this procedure is done in Surgical Outpatients and I would be knocked right out, requiring that a breathing tube be inserted. But as I’m obviously an early adopter, I’m having it done in the Diagnostic Imaging department instead with “twilight anesthesia” (yes, I’m the very first one). This means that I will be in a semi-conscious state. No pain, no anxiety, no need for a breathing tube, no memory of what happened. (This last part is unfortunate, because I’d really like to watch if I’m going to be semi-conscious. I have many questions.) 

In fact today during my teaching session (in which someone tried to teach me…) I asked the nurse how it’s done and waxed on about my vision of the procedure. She gave me a blank look. All she said was “There are 2 incisions.” Blew apart my whole vision, in which … of course I’m going to tell you … I think that the tube is inserted first – it looks like it has to run up and over the collar bone and then down into the Superior Vena Cava. (Remember that one from Biology class? It’s the large vein that runs in to the heart.) The disk is then attached to the tube, and slid under the skin. A couple of stitches later and it’s all done. But likely that’s not how it happens. If I come out of the twilight I will let you know what I see. 

Here is a professional diagram, proving that I am likely very close to being right. 

Diagram of Port-a-cath

How does it work?

Once it is in my chest, each week the nurse just has to poke the special needle through the skin into the top of the port and start the drip. It’s not inconvenient like a PICC line, which is inserted in the arm and has an external port that you have to look after. Apparently I can sleep on my stomach (although I’m not sure if it will be comfortable) and I can swim with it (you can’t with a PICC line). Plus it will make me look like I have an alien microchip implanted in my chest, and that’s cool. 

Bump in chest
See? Cool.

Why Not be a Wig Maker?

Well, I’m going to lose my hair. Chemo starts next week and I’m told I have about 10 days before it falls out. So I’ve decided to be proactive. I’m going to cut off my braids, grab my glue gun and make them into a version of a wig. Not kidding. 

I was inspired by Scout. On the run, she hacked off her pink tipped and therefore very obvious hair, fashioned two cute pigtails and then plopped a little black toque on her head. 

Scout
This is Scout. She’s a cute Netflix movie character that you really must meet. Dial up “About Scout”.

Well if she can do that and still look like a million bucks, so can I. Check it out: 

My plan

So on Monday I’m going to see Jenny, who has agreed to help me out. She will cut off my braids. (I realize that this could be a delicate procedure … I’ll have to secure the top somehow so it doesn’t unravel.) I’ll set them aside while she fixes up whatever is left on my head (seriously folks, it’s going to be gone in 2 weeks. Who cares??).

Then I’ll hot glue the braids to the inside of a comfie black beanie that I found laying around the house. (I’ll have the exact location of the braids marked on the beanie ahead of time, don’t you worry.) Later on I’ll sew a soft band of something over the hair, sandwiching the braids to the hat. This will help to avoid irritation from the glue and ends of hair rubbing against my bald bald head. 

This is what it should look like in the end, when I plop another hat on top. 

goofball
Of course I won’t have eyebrows…

So ya, that’s the plan. Handmade wig making. Why not?? FYI, a short haired wig (made with real hair) costs $1800 and long hair is around $2500. Can you believe that?? Omg. I’m going to get me a turban, plop it over my cool skull cap with braids and I’ll be good to go. 

 

at Lakeridge

Word of the Day: Receptor

Before my breast cancer journey began, I might have guessed that a receptor is a mechanical part of a TV tower. Or something like that. Perhaps I wasn’t paying attention in Biology classes. (Sorry Mr. Bailey! But thanks for the quilt!)

receptor definition

What are Receptors?

Turns out receptors are a big deal when it comes to breast cancer. There are three types of receptors on a breast cancer cell:

  • estrogen receptors
  • progesterone receptors
  • HER2 receptors (human epidural growth factor receptor 2)
breast cancer cell
This drawing is similar to one that my surgeon drew for me (I added labels for your convenience).

What does it mean?

When you have breast tissue removed and sent to the lab, they identify whether or not the 3 receptors are positive or negative:

POSITIVE: This means that the cancer cell IS receiving signals from that hormone or protein, telling the cell to grow.

NEGATIVE: The cancer cell IS NOT receiving signals from that hormone or protein to grow. 

Why is this important?

It determines your treatment. If any of the receptors come back Positive, then you are a candidate for “targeted therapy” – treatments that target specific characteristics of cancer cells. Good thing. Because other therapies like chemotherapy is a systemic therapy that targets all quickly growing cells … such as those that are in your gut, mouth, vagina, and that grow hair and nails. Yes, vagina. 

So, for example, if you test positive for one of the two hormone receptors, then you can use hormone therapy to cut off the supply of estrogen and / or progesterone to the cells. These are called targeted therapies. Boom! Dead cancer cells without the need to throw a ton of chemotherapy at your body. (Note: This is when a positive result is actually positive … not like my last post when a Negative is a Positive.)

With that in mind, a triple negative pathology is NASTY … since only chemotherapy can be used. 

What’s my pathology?

Let’s take a look (this is the 2nd path report btw):

results

My hormone receptors are both negative – so no hormone therapy for me. Move on to the HER2 receptors. Positive. WOOT WOOT!

What’s HER2?

HER2 are proteins that control how a healthy breast cell grows – until they stop working properly, get out of control and replicate in a crazy ass way.

This is the first thing I read about HER2, from the American Cancer Society website:

“For about 1 in 5 women with breast cancer, the cancer cells have too much of a growth-promoting protein known as HER2/neu (or just HER2) on their surface. These cancers, known as HER2-positive breast cancers, tend to grow and spread more aggressively. ”

Oh great. That doesn’t sound so positive… 

So what’s next?

So to be sure that there there are no rogue cells journeying around my body, we have to hit those HER2 positive cancer cells with some drugs. And the best treatment is to combine some of the targeted therapy (good) with some of the systemic therapy (not as good). This is what my oncologist has recommended:

1. Herceptin (this is the brand name – the medical name, trastuzumab, is hard to say):

  • This is a monoclonal antibody (a man-made immune system protein).
  • It blocks the ability of the cancer cells to receive chemical signals that tell the cells to grow.
  • Sometimes it is given alone and sometimes accompanied with chemotherapy.
  • Causes flu like side effects (fever, chills, nausea, muscle aches).
  • Oh, and it can cause congestive heart failure … more on that in another blog post…

2. Taxol (chemical name Paclitaxel)

  • One of the taxane chemotherapies that interfere with the cell’s ability to divide.
  • In order for it to find the cancer cells it needs to hitch a ride on herceptin, which incredibly knows where to go (because it’s targeted …. remember?).
  • It uses solvents to dissolve paclitaxel, the main ingredient, so the medicine can enter the bloodstream. I will have to take pre-medications to minimize reactions to the solvents. Oh can’t wait for that.

So that’s where we’re at folks!! I know what’s coming … just have to firm up a few dates and get myself fitted with a portacath! 

Oh so many more stories to come… like what I’m going to do with this stunning hair before I lose it all!! 

hair that will fall out