Like the low-grade nausea and fatigue that keep up their drumbeat as I write this, infusion number 5 is wearyingly familiar.
We make some progress during the “is she healthy enough for poison?” checkup. The shoulder pain that I had thought solved has come back. Bridget, one of the ace nurse practitioners, says that if a couple of days of muscle relaxants hasn’t worked, then it’s not going to work. Bridget suggests doubling the dose of the medicine I was first prescribed for “neuropathy,” the term of art to describe nerves going haywire for reasons that can’t exactly be pinpointed. So far, this seem to be doing the trick. So maybe my sore right arm isn’t due to an old injury after all.
Bridget says she’s glad that the mouth sore routine is working. She says to keep that up as needed. She suggests taking Nexium morning and night to shield my stomach from both chemo upset and the large doses of ibuprofen I’m taking. I point out that I’m taking 24 different prescription medications.
“But you won’t be on them forever,” Bridget says.
That’s some comfort, I guess.
“Do you have an appointment with Dr. Hwang?” Bridget asks.
This question catches me off guard. I knew I was going to have to have another surgery so that my surgeon, Dr. Hwang, could get “clean margins,” healthy tissue, on one remaining side of my cancer zone. Approximately half of women who have lumpectomies for ductal carcinoma in situ (DCIS) need a second surgery. DCIS is particularly difficult to excise since it can’t be seen with the naked eye. (I think of DCIS surgery as a bit like a surgical pin-the-tail-on-the-donkey, though I’m sure my surgeon wouldn’t like that characterization.)
But for some reason, I’d thought the order of business would be chemo-radiation-surgery, not chemo-surgery-radiation. I was bracing for the OR sometime in April or May, not March. Bridget points out that it’s a really bad idea to operate on irradiated skin.
“I could tell you horror stories,” she says.
I know there’s really no saying, “no,” so I nod. I don’t want to have a left breast that’s not only pleated but also a horror story. Still, I was hoping for skiing, not surgery, in March. Now, the whole ski season is in question. This sounds petty when we’re talking about life-threatening illness, I guess. But Tahoe in the winter with skis is heaven on earth to me. All I can do now is hope that the 300+ inches of snow up there last until May.
After the check-up, there’s blood work downstairs. For the first time, my red blood cells, hemoglobin and hematocrit (volume of red blood cells) are low, but not so low that I can’t do chemo.
So then it’s upstairs for the usual routine: weight (still haven’t lost any, no fair!), blood pressure, blood oxygenation, wet my hair for the freezy cap, wait for the chemo drugs to be mixed, put on the freezy cap, then carboplatin for an hour, taxotere for an hour, herceptin for half an hour. Chat with my husband and Mikiko, a dear friend who’s keeping us company for this round. Go home. Enjoy a day of steroid-infused wellness, then wait for the nausea, GI upset, fatigue and mouth sores to hit. I’m in the thick of that now. Not sure how long it will last. Hopefully it will clear before February 10. But even the malaise doesn’t lift, I cling to this: The next chemo is the last chemo. Can’t come too soon.