|Waiting for my ultrasound. Lots of pink in the breast cancer world.|
The doctor was so warm and friendly—after introducing himself he said he was really sorry to hear about my cancer and was very genuine about it. He explained why I was getting an ultrasound—that there were suspicious findings in my left breast—and that he was fairly certain it was a fibrous cyst but that we needed the ultrasound to get more information. If it still was unclear he would get me set up for a biopsy. I laid down on the bed and stared at the cloud images on the ceiling. It was sort of cheesy, but calming. I pulled my arm out of my gown and placed it up behind my head as instructed. It is inevitable my hands will fall asleep in this position, so I was ready for it. When I started to feel the pins and needles he allowed me to stretch it out straight to the side or put my hand on my forehead instead. As he performed the ultrasound I asked how he could tell the difference between a cyst and cancer on the screen. He showed me on the screen—the black circular areas with clean edges were cysts (I have a lot of them in my breasts apparently!) and the grayish jagged areas were cancer (which he was able to show me on my right breast). As he looked for the suspicious area in my left breast he said it was really difficult to find, but after some time he was able to locate it. He took some notes on how to find it again and said that even though he still thought it was a fibrous cyst he thought it was a good idea to go forward with a biopsy. He would need to perform it so that he could find the right area easily.
I sat up and cleaned the gel off my body and got my gown back in place and then followed him out into the hallway and then into his office. He called the front desk to make sure I got on his schedule before my chemo started. I thanked him for everything and went back to the dressing room to get my clothes on, and then was directed to the scheduling desk to confirm my appointment a week from that day. They gave me all the information on what things to avoid before my biopsy because of their blood thinning qualities and I was all set. I headed back to the main waiting room to get Bill and told him what was happening as we walked out. He got concerned and I told him it sounded hopeful that it wouldn't be cancer. The concern was valid—if it did turn out to be cancer it would be very possible it was a different type of cancer given that it wasn't metastasized from my known cancer. This could significantly change my treatment and my outcome.
Putting that concern aside for a minute we decided to spend some time outside of the hospital before my chemo consultation that afternoon. Unfortunately there isn't much to do in that area, but the weather was so nice that we decided to walk a mile to the nearest good coffee shop. I had some designs I needed to finish up for work so I brought my backpack with my computer. We got to the coffee shop and ordered a couple drinks to stay, sat down at a table, and I pulled my laptop out to work. There were other people working on laptops, but I couldn't figure out what the wifi was—every network that showed up didn't seem to belong to the shop. I went up to the counter and said that I couldn't find their wifi and he said, "We don't have wifi, that's why you can't find it". What kind of coffee shop doesn't have wifi?!? I guess I sort of understand not wanting people to sit there for hours using your free wifi while only buying a drip coffee, but at least put a sign on the door. I got on my phone and started searching for a place that we could get lunch and where I could work at the same time. I noticed a local place called Wishbone was nearby and after we finished our coffee Bill called to ask if they had wifi. They did!
We sat down and looked over the menu to figure out what was vegan, asked our waitress some questions, and ordered black bean cakes, millet cakes, mango chutney, squash, greens, and rice. I pulled out my computer and started working while overhearing two women next to me angrily discuss being laid off from another advertising agency. It was a bit uncomfortable because they probably didn't realize someone sitting next to them would know about their previous employer. Bill tried to draw a picture of me but I kept moving so it turned out pretty funny. Our food arrived and I continued working, by the time we were finished eating I was sending my work off for review. It was time to walk back to the hospital.
|Fashionable pink paper vest!|
The walk was nice, especially with the warm sun on our faces, but my backpack was starting to feel a little heavy. Bill offered to carry it but I wanted the exercise so I decided to push through. We got back to the hospital and met up with my oncologist to start the talk about what chemo would be like. The room was small and hot, and there was a student in there that sat across the table from me but never said a word, which was a bit awkward. We had so many questions to ask that it didn't really matter, we just focused on what we needed to know. My oncologist said her nurse would also be in to tell me more about the drugs they would be giving me and would give me specific information about what the side effects were, but that I was welcome to ask her any questions I had. On the walk back to the hospital earlier we had finalized our questions to make sure we weren't forgetting anything.
Somewhere in the middle of talking we made a realization—my oncologist had just said something about "every three weeks" when we were under the impression that I would be getting chemo once a week for 4 weeks (something both Bill and I had written down from our initial meeting with the doctors). I asked her and she looked confused and said, "Huh, yes there must have been a misunderstanding somewhere." So we're not sure what happened, but it was confirmed that I would be getting 6 cycles of chemo, once every 3 weeks. At first this made me upset because it wasn't the shortened timeline I had been planning on. But the more we thought about it the more we saw the benefits. I would have more time inbetween cycles to recover and feel normal. And the biggest benefit of all was that I would be able to work more, which significantly relieved some of our financial stresses.
We also discovered that the Lupron—the fertility drug—would not be covered by insurance at all so if we wanted to move forward with it we would need to pay out of pocket. This wasn't much of a surprise and we had been preparing ourselves for it. We were told that we could petition the company to give us a discount on the drug. But knowing that it would probably still be a large expense, we asked again what the chances were that I would go through early menopause, especially since I am so young. Basically what it sounded like was that I had a 50% chance with or without the drug and that my age did play significantly in my favor. I think that was the point that, without even discussing it, we decided to just let fate take it's course. I was so exhausted from making decisions and it didn't seem like the cost of the drug was worth it for the miniscule amount that it might help.
This was the appointment when my oncologist told me that my hair would 100% fall out. I was glad that I had prepared myself already by cutting my hair off. Sitting in her office with short hair and finding out that news made me feel like I was already one step ahead of it. It was also explained to me that I would be getting a port before my second round of chemo which would be surgically implanted into my chest and would be where they would administer my chemo & fluids as well as draw blood. The port is necessary and beneficial because over-use of my veins could cause them to collapse. I would have a consultation with the surgeon the day after my first treatment.
We wrapped up our discussion and then my oncologist turned me over to her nurse so that she could go through all the information I would need to know about my drugs. She had brought a big binder full of information to give me and we went through each page. The drugs I would be receiving during my chemo infusions were 2 drugs that target my HER2 (Herceptin and Perjeta) and one drug that would target my cancer (Taxotere). The HER2 drugs would be administered for a full year—beyond my chemo—and have few side effects for most people. My hair would start to grow back at the end of my 6 cycles, when Taxotere is removed from my regimen. I would also be given some drugs through infusion prior to Taxotere to help with different side effects: one is Benadryl to prevent an allergic reaction, some anti-nausea drugs, and a few other drugs. I should take Zyrtec every day, they also recommended daily Prilosec (but I decided not to use this and deal with heartburn in a more natural way), and I was prescribed a sleep aid and anti-nausea medications (which I also chose not to take and deal with in more natural ways). I was allowed to take supplements as long as I wasn't taking super high doses of anything because my liver will already be processing a lot of stuff.
The side effects I could have: fatigue, nausea, loss of appetite, diarrhea, constipation, neuropathy (numbness of hands and feet), swollen ankles from liquid retention, full body hair loss, mouth and throat sores, dry mouth, forgetfulness, hot flashes & night sweats (from temporary menopause), fever, dry skin, rash, and more. We were warned that if my temperature reached 101.1 or higher I needed to page the doctor and immediately go to the ER. Throwing up was not tolerated and if I was I needed to let them know right away so they could adjust my medications. We asked a lot of questions and were able to get a lot of answers. I think we were actually the last people in the office that evening! It was so great that my nurse stayed as late as necessary to make sure we were comfortable and prepared for everything. Before leaving for the day they had me stop into another area of the office to pick up plastic jugs for my 24 hour urine. That Sunday I would have to pee into these jugs for 24 hours and store it in my fridge (fun!). At first they just handed me one jug and I said, "umm, I drink a lot of water so I don't know if this will be enough..." and she handed me a second one.
We stopped and got some food on the way home and I made phone calls to both my mom—who was in Iowa helping my grandmother after her back surgery—and my dad—who was back home. It was a lot of information to relay, talk over with Bill, and sit with. I felt a bit overwhelmed but also glad that I finally had a plan set before me. It made everything feel a little less daunting.