The Journey Now Part 5: Back in the Saddle

Today, I'm back in the saddle.  Finally!

My numbers were up, across the board. Everything from my white blood count to my neutrophils. My calcium was high, my red blood count remains a bit low.  I saw my oncologist yesterday, and we talked about my experience last time.  She can't change the Cytoxan dose, and there is just one more, but she lowered the Abraxane. Almost everyone agrees but me that it was the Abraxane, not the Cytoxan, that caused the crash and the misery.

Today, my nurse scolded me: "If you had such a rough time, you should have called! Maybe you needed hydration, and we can call for pain meds.  Don't wait next time! Or go right to the ER," she said.

Hubby reminded me: I did call, and pretty much got a yawn. This might have been in part because it was Superbowl weekend.  But OK; point taken. Don't suffer, bitch. I will, next time.

The Abraxane-only infusion was uneventful. We made some more progress on The Hobbit; we are almost through. And there's this comforting thought: JUST FOUR MORE!

Please let me know how you're doing.

Judging Lesley Gore: A Quick Rant

Today, I was saddened to learn that the wonderful Lesley Gore passed. Each news article I read said only "died of cancer."  So I traveled to www.lesleygorefanclub.com where I read something that just infuriates me, even though I know why they absolutely had to publish this in just this way:

Lesley Gore, 1960s Pop Icon, Dead at 68 

NEW YORK, NY, February 16, 2015 -- Lesley Gore, who shot to fame in 1963 at age 16 with the classic pop song, “It’s My Party (And I’ll Cry if I Want To”) and made the pre-women’s movement song “You Don’t Own Me,” a feminist anthem for many, passed away today at New York University Langone Medical Center in New York City. The cause was lung cancer. Gore, who was a non-smoker, was 68. 

As I explained to you in my "Things not to say or do" post, there is often a judgmental factor people have about cancer, especially certain types. So now, without that "non-smoker" clause, Lesley Gore might be remembered, not for her tremendous courage, her feminism or her talent, but her lung cancer. Her obituary will always be immediately followed by "she was a non-smoker."  

Rant over. Rest in peace, dear Lesley. Condolences to her partner of 23 years and family. Feel free to join me in the comments, on Twitter, Facebook or Inspire.com.

Two Weeks in Limbo

Status Update

"Neutrophils" by Dr Graham Beards - Own work.
Licensed under CC BY-SA 3.0 - Wikimedia Commons 

For the last two weeks, I've been in chemo limbo. Because of the terrible, horrible no good, very bad worst chemo I have ever experienced two weeks ago, my bloodwork came in far too low last week.  My white blood count was low, my neutrophils were bordering on dangerously low. Chemo would be dangerous under these circumstances.  

I was told we would wait a week. I was so very unhappy, because my whole life is on hold for this chemo, and this would delay my return further.  I tried to adjust my attitude and look at this like a vacation:  I could eat more normally again, and I felt generally better.  So much better, I was sure this week's numbers would be stellar.

They were far worse:

• My white blood count is lower.
• My red blood count is lower and the cells look anemic.
• My neutrophils (the infection-fighting white blood cells) suggest that my immune system is in full crash mode: from .8 last week to .2 this week.

My doctor has delayed me for another week. Her nurse told me that she lowered the dosage of my chemo.

"Did she lower the Abraxane or the Cytoxan?  I was doing well on the Abraxane, but I think got very, very sick from the Cytoxan."

"The Abraxane."

"Really? Because I handle the Abraxane just fine. But I'm not sure I have the courage to do another round of Cytoxan. I think it nearly killed me."

I will see the doctor face to face, next week.  Until then, I remain in limbo:

• I may not go out in public at all.
• I may not peel my own fruit, and only fruit with peels or fruit that has been cooked are allowed.
• I can't have raw vegetables, either.
• I can't pick up after my dog.
• I shouldn't clean my house, especially, ahem, certain areas.
• Lady Macbeth and I should have red, raw hands from all that washing.

I'm pretty sure I didn't sign up for all of this. I am in deep doubt that I am doing the right thing. I fear long term side effects, like the leukemia that some patients experience post-chemo.  My body may be signaling me.

But that one in four recurrence number...it's just so high. I need to screw my courage to the sticking place, for sure, next week.

How do you screw your courage to the sticking place? Let me know in the comments, on Twitter, Facebook or Inspire.com.

Things You Should Never Say or Do to a Cancer Survivor

Author's note: I've just updated this, in two ways: 

• I wanted to include calling thyroid cancer "the good cancer."  
• I took out not asking how I'm doing. I realized that's unreasonable; you want to know. Maybe not as often?

As I was crawling into bed for the night, Messenger buzzed. It was an old friend. This conversation, over the next few minutes, became my go-to example for what to never say to a cancer survivor. I’ve changed relevant facts because I don’t want to embarrass them; I want you to see how easy it is to be an ass. I put my Daria-inspired thoughts in italics.

• How are you feeling? Hope you have a good New Years and get better! Had first chemo correct? Notice anything?

Thanks. I am hanging in.
Yep day xx post
Been interesting
Lots of side effects. Side effects from stuff they give you for the side effects.
...Time for me to hit the sack; its midnight!

• Is this breast cancer?  Didn't you have before?
• I bet you feel bad.

Yes and yes. The chemo was easier before.

• Same area?

...Is this person drunk? Seriously?
Yes it is a recurrence but more aggressive.

• Why don't you remove your breast, won't that help?

...I see that you pay careful attention to what I post!!! How could anyone think it was ok to ask that? 

I did. Most chemo is designed to catch the cells that hang around to cause trouble again. Micro cancers. I am improving my odds of not getting another recurrence.

• That is bummer. Maybe chemo was easy first while you expected worse, this time opposite. That's good, but this tougher regimen will kick your but. (sic)

...Why am I bothering?  How do I just get rid of this person?

• It and being positive is all you can do. That really makes a huge difference. You know (SOME RANDOM PERSON) had it real bad and has been good. She has a great attitude.

...Oh, jeez, here we go. How do you know? You hold her head over the toilet?
Yep. Thank you for checking in. Means a lot.

• It's scary, you should be checked on.

...Yeah, I only have $100’s of thousands of dollars invested in that so far, I’ll be sure to get right to your suggestion.

• We had a family friend who died years ago had cancer. He fought hard, was in remission three times. What he had was very bad type. He lived about 8 years; three more than they thought. Never have I known anyone so positive. He wore that bald head proud too!

It leaves you with a smile to think about him, doesn't it? That's a special person.
...Because, what this person is really telling me is that they missed this dude. At the same time, dude, whoever and wherever you may be, good job holding your tongue!

• He was a very large man, fat, I think that actually helped treatments had him so sick he would have wasted away. We went to Lugnuts game. He is bald, people stare....He could  of cared less. He was a beautiful person.

....WTH? Did you just tell me that a fat man was able to survive longer because he was fat? Does every thought that crosses your mind find its way to your keyboard? What is wrong with you? 

Keep him in your heart when times get tough. He's still with you. Listen I need to get some zzzz's.

Me too.
Rest, stay strong

ty

....ARRRRRRGGGG!!!

Here is my list of things you should never say or do:

1. Tell me, "My (name close relative, friend, etc) had cancer..."
You can tell from my story why this is a horrible thing to do. When I first got cancer decades ago, I literally clung for hope on the stories of long-time survivors. I can’t tell you what that meant to me! I also can’t tell you how it hurt to lose a few folks I met along the way…the gals and guys who transitioned from battle to legend. So, the last thing I want is someone else's sad baggage. 

2. Ask me: "How did you get cancer?” "What did you do (wrong)?"

I’m always amazed that people don’t have the manners not to ask. I am asked so often, that I have a pretty standard answer, but here's the real answer:

WE NEVER, EVER KNOW why we got cancer. Oh, we can guess: Doctors like to say genetics, but that’s proving thin. The real answer? One or more cells (for whatever reason) forgot how to die, and then started a party in my body. End of story.

Like lung-cancer patients, I’ve been asked if I smoked. (Answer: yes, for a time, long ago. I also ran four miles a day in my 30s and 40s and ate fresh, home-grown foods.) It remains much less likely a contributor than, say, the high-estrogen birth control pills the doctors gave me for cramps, the radiation treatments that may have led to later cancers, and a host of other contributors, like the above-ground nuclear testing fallout we all played outside under as children of the 60s.

Think about your motivation for asking a cancer patient why: You want to avoid my fate! You hope that you can check off that box and say, "Well, I'm not going to die a horrible death."  Worse, there's a bit of judgement: "It was her character flaw that caused her cancer."  However far short I may fall of sainthood, I can tell you that lots of folks do much worse and they don't get cancer. 

I suggest that's trying to figure out why is a fool's errand. The fact is, we have more carcinogens in our daily lives than at any time in human history. So, stop victim-blaming and figure out how you can make the world healthier.  

3. Call any cancer, especially thyroid cancer, "the good cancer."
I have had nearly every one of my endocrinologists use this. I fired one of them, but I realized that the practice is just too rife. Still, it is blindingly inappropriate. The challenges of thyroid cancer, any cancer, are beyond understanding until you have been there. Even the article that I link to understates some of the issues: we remain symptomatic and often unwell throughout our lives, especially when on standard care. The medical community dismisses these issues, reflecting a level of malpractice, in my opinion. Those who have battled other cancers know that their doctors are working hard to improve care for them. Not so with thyroid cancer, it seems. Doctors seem content to perform thryoidectomies, then prescribe a less-than-effective pill, and dismiss your concerns after.  That's pretty outrageous. It's not the good cancer *at all.*

4. Ask (repeatedly) "Can I do anything/clean/shop?"
Look, I can’t stand the idea that I’m impaired in any way. I don’t want to be in a position to need help, so accepting it means I have to acknowledge that I can’t manage. Just don’t ask. Do something that has your heart in it, if you want, or ask Brian what I need, but for heaven’s sake stop asking me. 

5. Say, "You are strong; you will get through this."
Trust me, I’m not. I’m regularly reduced to impotent, flowing tears of despair when I'm sick. And hell, I may actually die. You don’t know! I have endurance, not strength. But thanks for the thought.

6. Exhort me to "Stay positive."
This is truly unfair to a cancer survivor. Want to know how positivity works out? Read this blog.

7. Tell me, "I saw an article and you should..."

I have had some downright dangerous advice from my friends. Some of the things people close to me have suggested would lead straight to another cancer or worse.  

Many of you know me by now. You probably know that I’ve researched this to the molecular level, and taken it to the metaphysical. I make informed, clear-headed, tough choices. Unless you are being paid, by me, to give me medical advice, I probably find it unwelcome. (Hell, most of the time, I find the advice of the ones I AM paying to be unwelcome!)

8. Say, "God doesn't give you more than you can handle."
I had a Christian friend, years ago, who survived a horrible robbery/rape that left her back permanently damaged (from fighting back!) She was the one who clued me in: the Bible never said that. It makes those who feel at the end of their rope ashamed, not comforted. Fellow Christians, do you ever take a moment to think about how it makes people feel who don’t believe? That's a never, ever.

9. Say "I know how you feel."  
No, you don’t. I don’t how my fellow travelers feel. You can’t possibly know how I feel; it is the human condition. Generally speaking, we should never tell someone we know how they feel.

10. Post a cancer meme or fundraiser on my Facebook page. This goes quadruple for the chain letter types.

A short while ago more than one friend did this very thing: sent me a "You've been specially selected for a blessing" meme that exhorted me to immediately send it to 15 friends to obtain the blessing. At least it didn't threaten a curse if I didn't!  

Another is the "Some people just want to beat cancer meme."  It always ends with "I bet you won't repost." I believe I have seen it on my timeline over 50 times so far.  I won't.

Please don't ever send me these.

Please don't send me fundraisers. First, because I should be getting from these folks, not giving. Also, most of the fundraisers are scams. Even the legitimate ones are notoriously poor at using funds for actual research, while legitimate need goes unmet. If you aren't sure how the funds will be handled, please don't. Want a meaningful cause? Everyone needs to support metastatic cancer research.

I know you want to express solidarity. Let me suggest inspiration, funny posts, cat videos, screaming goats, anything but one more "Bet you won't repost this" cancer meme.

I know you love me, I know you want to help. Your good thoughts and your prayers go far in sustaining me. At the same time, I will appreciate it if you take a moment to think before you say or do. 

Here's another take on the what not to do from Yahoo!

Add your "what-not-to-dos" in the comments, on Twitter, Facebook or Inpsire.com.

Side Effects, Part 2: OMG!

I promised I'd be honest. You're not going to like it, though. I want you to be clear about it all. I'm not a hero; this isn't a 3-day walk in a park. God reminded me of my humanity this week. Turns out, I'm incredibly human. 

This was big chemo week: both the Cytoxan and the Abraxane. I had a reaction like I've never had before, however. The first intractable symptom was a growing fever, waking up Saturday morning, 1.5 days after chemo. I reached 99.9 but I didn't top the 100.4 that would send me automatically to the ER. 

I felt incredible, deep bone pain: I had to text hubby downstairs to come help me. As you remember, that symptom means my white blood counts are far too low. I got those somewhat resolved with Tylenol and Claritin, but the nose sores and the taste of metal/blood were ever-present -- much, much worse than ever. I couldn't make them go away. My GI felt like it no longer worked, like a subway that has stopped and is backing up dangerously. It felt like my system was turning into metal itself. 

My Chemo Crash!

After days of this, thoughts turned pretty dark, and any solution seemed, well, reasonable. It became easy for me to ideate that the solution was to just be done. It would solve so much: the pain would stop. My family would have the money that is currently being poured into my veins to hold the cancer away. (My life insurance is pretty good, you know.) If I die now, maybe that would spare me a horrible drama later. I know, that's not a good place to be.  So I just prayed to find relief. 

My husband was wonderful. He kept my hydrated, medicated and comforted the best he could. I obviously did hang in there of course; if this was going to be my death, that day wasn't going to be Superbowl Sunday, apparently. Gradually, that day, it resolved. I was even able to watch and enjoy the Superbowl. So, prayer answered. Yesterday, the sun shone, and I napped. It was over, more or less. Thank you, God? 

I don't know how my fellow travelers do this; how some of them handle much worse. I bless and marvel at them; I know I never want to experience this again. I still have one more big chemo, and it's likely to be worse yet. I'm going to have to steel my warrior aspect for it. I told my husband to force me through the doors, if he has to.

By the way, before my fellow Christians give me the "God doesn't ask you to suffer more than you can handle" speech, please read this. Never, ever say that. It's a terrible thing to say. I'll make another post of things you should never say to a cancer survivor.

Let me know your coping techniques here in the comments, or on Twitter, Facebook or Inspire.com.

Side Effects

The Chemo Experience

I promised I would discuss my experience honestly, so I will tell you about the side effects.

Let's start with my CMF chemo, 17 years ago.  They gave me a list of possible side effects, and I had many of them. 

Nausea and Vomiting, GI issues

I never threw up, but I felt like I had been poisoned. I was nauseated for a few days, I ate strangely, like I was pregnant. I ate only mashed potatoes for a few days. I couldn't go to the bathroom normally, again for one or two days. This was before the days of probiotics. 

Fatigue

I was also getting radiation at the same time.  My blood counts got very low in this period. I was a bit tired toward the end of the radiation, and chemo was once delayed while my blood counts returned  and they hung a bag of blood in the hospital. I was tired.

Thinning Hair/Bad Nails

This was considered a less aggressive therapy, so my hair only thinned. I remember walking by a building with mirrored windows on a windy day, and seeing my hair fly up. It shocked me how thin it was. (Of course, this was nothing compared to now.)  My nails weren't great to begin with, and they got a little worse.

Fertility/Menopause

I had already had one test that suggested I was looking at menopause. CMF did it for me. I love it when the nurses ask, "date of your last period?" and I say "1996."  

Weight Gain

On average, most chemo patients gain weight. A few people do lose weight but that happens less often, and sometimes the reasons are not good. Most of us gain 35 pounds, on average. My personal belief is that our pancreas and our livers take a hit, making it harder for them to process our foods as well as pre-chemo; like having a fatty liver. Good luck losing weight using any of the normal methods! I gained that 35 pounds and I could do nothing about it.  I began to develop an eating disorder until I learned to accept my new normal.

Cognitive/Emotional

There was one more they didn't tell me about, because they didn't know: it's called "chemo brain."  These effects are long lasting. Recent studies acknowledge that we are killing brain cells while we chase our cancers. We live longer, but we give up IQ points in the process. Now that's one helluva price, isn't it? I also include emotional effects here, because your brain was injured all over. I was depressed post-chemo. I'm pretty comfortable attributing that to treatment.  

The effects were subtle: trouble remembering things, a hit with concentration and attention, and fragile emotions.  When I first learned that my suspicions were correct, I was once again in a mighty fury! No one told me that this might happen! Some feel it was a version of sexism that kept the doctors from recognizing the complaint as an actual side effect.  It wasn't until the 2000s that they admitted "well, yeah, it looks like chemo is bad for the brain."  You think?

I have already mentioned that I didn't let that stop me, however. I went on to get my technology management-related Master's a few years later, magna cum laude. I aced statistics, and had, until then, considered myself math-impaired. (Not really, it turns out...I just had bad teachers.) I don't think the cognitive deficit was long-lasting, in my case.  

There are a host of other side effects, but I didn't notice them as much.  

So, how am I doing so far?

Because of the allergy, we changed my chemo to Abraxane. The side effects are similar, but the two experiences are different.  For one thing, I go weekly, so the GI issues tend to crop up again each week.  Here's the chart you just know I'd have to have, to track my progress:

My Chemo Log Chart:
Blue= My subjective rating of how I feel, 1-10.
Red = How my incision is doing. Note the zero! Finally!

As you can see, there used to be a three-week rhythm, but now there is a weekly rhythm: I feel good until chemo, then I feel less great, then I slowly recover.  The Cytoxan and Abraxane weeks tend to be worse than the Abraxane-only.

The list of side effects is similar:

Nausea and GI Issues

As with my first experience, I have a feeling of flatness, of being mildly nauseated, most of the week. I never really do throw up, but the day after chemo, I usually run for the nausea meds at some point. I also have a taste of metal in my mouth. I'm using non-metallic utensils and dishes to help. My GI is off, of course, so probiotics are my friend. Pepcid helps the heartburn. This all is much better than the old Taxotere chemo, however. I drink 3 liters of water every day. 

Hair Loss/Bad Nails/Bad Skin

My hair looks just like my co-workers' four-month-old, only it's less adorable on me.  I have some, just not much. People like it better when I wear my hats. (Thank you, everyone.) I'm obsessing over my nails. They can fall off; I really do not want that to happen. So far, so

Look, mom, no hair!

good. 

I have yet another rash, but not really hives; it is much more like contact dermatitis. The doc says it is also a chemo rash. I'm to control it with antihistamines and steroids.

Pain

Some of us have bone pain, a feeling like the flu is coming on. That happens because the bones are working extra hard to make white blood cells. It was very difficult with the Neulasta (given for the three-week chemo, but not for Abraxane.) But, I still feel it some days now. Know what helps? Antihistamines! Remember that for your next flu, when your body aches. 

Fatigue

I'm very fatigued this time. I start out well in the morning, but I wear out quickly.  I take naps often.

Infection

Those white blood cells are taking a big hit. The doctors warn me to go to the ER if my temp rises to just 100.4. Anything might become infected. I often wear surgical masks in public or to go shopping now.

Mouth/Throat Sores/Dry Eyes

My mouth is fine, and my throat gets scratchy but I really feel it in my nose! Ick!...that's all I'm going to say.  My eyes just got iffy a few days ago. Humidity helps.

Weight Gain

Yep. More weight. Nothing I can do. I can promise you I'm not eating as much as I normally do, but the scale ticks up. Some of this may be attributable to the generous doses of corticosteroids I've consumed, but I think little gal that I was in my 20s and 30s will never be back, between thyroid meds and this. It is what it is.

Healing

As you remember, I was still healing my mastectomy incision. It's nearly February (it was made in October.) As of last Sunday, I think I'm finally there.  I still won't stress the incision with too much movement just yet.

Cognitive/Emotional
I've told my hubby to follow me around to make sure I shut off the stove and close doors. I do have a bit of short-term memory loss. I am also emotional; I can panic or feel sad easily -- and to be honest, I just let them flow. I don't have to be professional or manage myself in public. Overall, I'm not depressed or angry this round, at least not so far. There is a huge difference in my attitude this time around.

But that story will be another post!

Let me know how you are in the comments, or on Twitter, Facebook or Inspire.com.

The Journey Now: Part 4

Pathology and Numbers

After the shock of the incision burst, I began to recover.  I got a copy of my pathology report as my stitches healed. There are so many more dimensions to the process of staging breast cancer now:

 Diagnosis:

• Invasive Ductal Carcinoma, moderately differentiated (It's been upgraded! Lucky me!) Margins negative (they got it all.)
• Foci of Ductal carcinoma in situ, intermediate grade. Margins negative.

• Largest tumor size: 1.8cm (Ok, that's a lot bigger than the September ultrasound.)
• Histologic grade: Score 3 -- Less than 10% of the tumor is forming fingers to invade with (that's good.)
• Nuclear pleomorphism: Score 2.  It looks just like cancer cells look.
• Mitotic Rate: Score 2  How fast cells are dividing -- this is good.
• Total Nottingham score:  G2, Moderately differentiated.  I WIN 6 to 7 POINTS!!!

It appears there is only the one tumor, still in situ (meaning in site, in a single organ like a duct). There is no invasion of my lymph nodes that they can see.  

• ER (Estrogen Receptor) Positive -- 100%
• PR (Progesterone Receptor) Positive -- 1%

Both of these mean that hormonal treatments like Tamoxifen are likely to work. 

HER2: equivocal or negative (depending which report you read) 

TMN descriptors (short hand for the doctors to describe and stage the tumor):  pT1c: the tumor is stage I due to size, but a moderate grade based on the total tumor score.  Category pNX: there were no nodes because they were no longer there) and not metastatic from what they could see. The tumor is very similar and very close to the original (right next to the marker my surgeon left.) It is recurrent.

It looks like we caught it early.  If this had been the 90s, I might have been placed on a hormonal treatment like Tamoxifen and we'd be done. But there's a new test in town, pardner!

My surgeon's office belatedly sent samples of the tumor off for the latest in cancer diagnoses:  Oncotyping.  Essentially, a lab looks at the genes, and determines how aggressive they are by how much  Ribonucleic acid (RNA) they express. The genes are rated on a score of 0 to 100.  The oncologists (cancer docs) use this rule of thumb:

This made an impression.

• Under 18, no chemo necessary.
• 18 to 26, maybe.
• Above 26...oh, yeah. You need chemo.

I waited for two weeks to get my score, and when I learned, I was devastated:  34.  

My 10 year risk of recurrence on Tamoxifen alone was 23%.  Almost one in four. Too high!  With chemo, it drops to 6 or 7%.  

This is a good time for me to talk about how I feel about chemo.  I HATE CHEMO!!!  There, I said it.  I thought it would kill me the first time around, and as I got smug about recurrence, I allowed the thought to creep into my head that I would never, ever agree to chemo again.  It had been sooo devastating! Confronted with those numbers, I changed my mind.  I still have lots to do. Chemo it is. 

Absolute Benefit of Chemo on recurrence after 10 years.
Note the big difference in the solid (Tamoxifen)
vs. dotted (Chemo + Tamoxifen) line.

My oncologist told me this is going to be a bit more difficult, but for a shorter time: just 12 weeks, with chemo administered once every three:  A dose of Cytoxan (which was the "C" in the CMF chemo I had had years ago) and something newer: Taxotere, a cytotoxic drug made from the Yew tree.  

"Twelve weeks? Ok. Will I be able to work? I did the last time."
"No. This is more aggressive. I don't want you trying to work"  Hubby silently signs "yes!" He doesn't want me to be heroic.
"Will I lose my hair?"
"Everyone is different, but almost certainly." 

Great.  No hiding my cancer now. For the first time, people will know I am locked in a cancer battle. I have, up to this point, told very few my story.  Now, that's all gone. I would have to go on disability, and anyone who saw me would know. Including my daughter! She was little the first time around; I don't really want her to see me sick.

"I have plans to see my daughter in Texas after Christmas. Can I wait until after the holidays?"   

"No, not really. We can't wait that long, but you should be able to travel between chemos. You may not feel well, but you can travel." 

Next, we had to confront the possibility of metastasis.  Although the pathology report suggested everything was ok, I had actually had a phantom pain in my back/side/under ribs for weeks. It could be quite bothersome. My doctor sent me in for an ultrasound.

Cancer scare time:  
1. 10 mm echogenic lesion in the right hepatic lobe (MY LIVER!) is incompletely characterized. Although findings may relate to a hepatic hemangioma,given history of breast carcinoma malignancy is not excluded. Further evaluation with dedicated liver CT or MRI is recommended.
2. Multiple nonshadowing echogenic foci adherent to the gallbladder wall are suspicious of gallbladder polyps measuring up to 5 mm. A six-month followup exam is recommended to reassess.

AAAHHHHH! Any finding of cancer instantly puts me in Stage IV. Metastatic cancer is a whole new world. Next up, a PET Scan: 
Impression:1. No mass within the liver. The findings seen on ultrasound likely correspond to the small amount of diaphragmatic fat intimately associated along the posterior aspect of the liver.
Gallbladder and everything else looks good. Ok, back on the shelf, you little bugger. I am, officially, pM0 (no metastasis.)

Round 1 seemed to go well. I handled chemo with most of the usual and familiar side effects. It wasn't until day 17 that I had a problem.  It started with itchy palms on my way back home from Texas. Because I had had a seafood dinner in Louisiana, I thought I might have developed a sudden food allergy.  

But the next day, in the RV, I awoke covered in hives. By that afternoon, I knew I needed to see a doctor. We found a great ER in Decatur, GA. They got me loaded up on steroids and antihistamines, but they only lasted a few hours. We stopped again when my face and tongue began to swell, but the doctor in Tennessee didn't have anything more to offer than an epipen, just in case. Thank God we were in the RV where I could just lay back and try not to itch. Poor Brian, he had to put pedal to the metal. The next night we arrived home, but we were exhausted. I decided I would go to the ER the next day, if I was no better.  And I was definitely no better.  

I saw an allergist that afternoon.  She consulted with my oncologist.  They called it, no doubt about it: I was allergic to the chemo! 

Kudos to the allergist: there is a really powerful antihistamine, and I began to get better. But what would happen with my chemo?  My oncologist had an answer.

There is a version of Taxotere that is much easier on the system. It's called Abraxane.  It's the same cytotoxic drug, but instead of being dissolved in a solvent (which was the source of my allergy) it is dissolved in albumin...egg white protien.  It's given every week, however. Some believe it is more efficacious, both because it is given more frequently in smaller doses, but also because it "sticks" to cells better in the albumin.

Why didn't I get this all along?  One word: insurance.

I am heading for Round 3a this week. (The Cytoxan is still given every third week, so four total rounds are still anticipated.) I do tolerate the Abraxane better, but I do have side effects. More on those, next post.

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