Today is exactly 2 weeks after my bilateral mastectomy. I was able to scale down the pain medication yesterday to a total of 3. At night, I took one rather than two. I didn't sleep as deeply, and didn't go to sleep right away when I woke up for a "nature break" in the middle of the night. But I did get a full night of sleep. It could have just been psychological, knowing I took less before bed.
I had my appointment with Dr. P today to see what the rest of my treatment is going to look like. Mom and Eric both went with me, and we recorded it just in case we forgot any details. Not only is the support nice, it is good to have another set of eyes/ears and brain in the room. I was very glad that he did not give me a percentage chance of survival, nor did he dwell on the stage of the cancer.
As I expected, Dr. P is recommending 6 rounds of chemotherapy and then a course of radiation, and then hormonal therapy for 5 years afterwards. The radiation is on the menu because I had more than 4 positive lymph nodes. I asked him if I do chemo, doesn't that "kill" all the bad cells? Isn't radiation then overkill? He thought that was a good question. It basically comes down to doing all you can to make sure the cancer is gone. Each treatment attacks it slightly differently. He thought the chemo and hormonal treatment was the most important in my case. I have time to think about radiation. I definitely want to throw all my weapons at this enemy and kick it once.
We do have a decision to make, however. When it comes to the chemo, the traditional cocktail in cases like mine has been a mix of three drugs: taxotere; cytoxan; and adriamycin. There apparently is debate in the oncology community about whether or not adriamycin is really necessary for breast cancer. The camps are about 50/50. The trend seems to be to leave out the adriamycin. There is a clinical trial going on that I am eligible to participate in that will answer that question. Too bad it isn't already answered. Because now I have to decide whether or not to do the chemo with or without adriamycin. I asked Dr. P which camp he was in, because he wasn't pushing one over the other. (A good sign, I think). He said he falls into the side of leaving it out. Adriamycin can cause damage to the heart muscle, and it can also cause leukemia. On the other hand, it is part of the traditional treatment that has put breast cancer survival rates in the 90th percentile.
I trust Dr. P. We definitely are going to think about it more, but for now, he ordered the chemo without the adriamycin. Thank God that Eric knows how to research this stuff. He's already looking into it. If we decide we want the adriamycin all we have to do is call and he'll add it to the mix.
Dr. P also examined me. He said everything looked good. I was glad, because yesterday I noticed some fluid build up on my right chest area. (I don't think I can say breast..its not there anymore.) It was freaky. I would lightly poke it and it would undulate like a water balloon. It wasn't a lot, but it was gross. He said that was very small, and not to worry about it. He asked about my mobility and seemed to be positive about what I have been doing to rehabilitate myself from surgery. I asked him about the pain meds, and he said it was better to be on pain meds and be able to stretch than to be off of them and immobile. He did not seem to think continued use of them was unreasonable. In fact, he almost seemed to encourage me to use it to avoid pain.
He's also prescribing some medications to go along with the chemo. First is dexamethasone. I'm supposed to take that the day before, the day of, and the day after each chemo treatment. The second is Zofran for nausea. The third is the antibiotic Cipro to take around day 5 of the chemo cycle to help ward off infections when my white blood cell count is low. I'm going to put all of these on a calendar so I can keep track of what to take on each day.
The big question is...when does it all start? My first chemo round will be in 2 weeks, on August 20th. After that, its every 3 weeks until my last dose on December 3rd. I go in and see Dr. P the day before the next dose. I also have to have a blood draw the day before each dose. I'm glad they put my Dr. P appointments the day before, because I can just go over to the lab and have the blood draw at the same time.
I'm glad I will be lucid on August 18th. That's a big day for Olivier. We will go over to the middle school and he'll pick up his schedule and books. He'll also get his school picture done, get his student ID and be able to walk around the campus and find his classrooms. I didn't want to be dopey for that. It is really important, and I was going to drag myself out of bed if need be to go with him. I'm glad I won't have to do that! Middle school is a big step and I want to be present for Olivier as much as possible to help him adjust.
My prayer requests:
- That my body continue to heal. I've got 2 weeks to get in as good of shape as I can for chemo. I also hope to be able to sleep as I begin to scale down the pain meds at night.
- For wisdom as we research and make a decision on the adriamyicn.
- That our family treat each other with an extra dose of grace and patience. Isn't it sad we sometimes treat total strangers better than we do those we say we love? This is a tough journey for each of us individually as well as a family. We need continual refilling of the Holy Spirit upon our home and in our lives. We're very leaky!