Pick Your Poison - It Just May Be The Devil You Know

There’s an old saying: “Pick your poison”.  According to the Urban Dictionary, “Pick your Poison” is what you say when someone is supposed to choose between two horrible options, i.e. “you could chop off your toe or you can stab yourself with that piece of broken glass”. Well, there ya have it.  Yep, a choice between two horrible options. How does one choose when one finds one’s self in such a dilemma? Some go with “the devil you know”. And it seems that’s what I am doing to do.

If you have been following along, you know that I had a rare reaction to the drug, Taxol. A rash, more like an itchy sunburn. And as you recall, my oncologist wanted to switch me to a newer, more pure form of the drug – Abraxene, but my insurance company initially DENIED her request. Well, she was persistent and good at what she does and got the insurance company to AGREE to allow me to use the drug on my third treatment – that was last Thursday. Good news, right? This new drug had almost NO reactions reported, only takes 30 minutes to transfuse (as opposed to 2 ½ hours) and required no pre-meds (no steroids, no anti-nausea meds, no antihistamines). Great!

I felt good about our decision to change to this new drug. My doctor was over the moon she was able to get it approved for me. The regimen under this new drug was two weeks on, one week off. This is because the about the only issue with the drug was the potential for low white blood cells (WBC) counts. To date, my WBC have held pretty steady. Close to or in the “normal range”, but with this drug, they could take a nose dive, so the week off is to allow my body and WBC count to recover. Great! I’d be able to complete the rest of my treatment still on time, but have the luxury of taking three of the remaining weeks off from chemo! Hooray! As predicted, my treatment lasted all of 30 minutes and we headed home.

You just gotta know where this is all going, right?

Yep, I had a reaction to the “non-reaction drug”, too. This time, my face is numb. The inside of my mouth is numb, my tongue is numb (can’t taste a thing). In fact, we spend the weekend waiting to call 911 due to anaphylactic shock (thank god it didn’t come to that). Needless to say, we are back to square one.  Figures that I would “breeze” through the toughest rounds of chemo and then have issues with the “easier” rounds…..Damn it.

I have faith in my oncologist. She will figure out a path forward. I have to have faith that she will. Will she put me back on Taxol (at least my face didn’t go numb on it) or will she keep me on Abraxane and onboard with nasty steroids and anti-histamines? She’s got until Thursday to figure it out.

Looking, Hoping, Searching for Answers

With my chemo treatments coming EVERY week now, I realize my posts may become shorter and pithier as I try and describe my various feelings and experiences. Much of this time:  emotions, side effects, etc., have become routine – mundane almost – in their regularity and familiarity. Although, I’m not immune to the abnormal reaction here or there (as you will read below) – my goal is to stay as boring and “average’ as possible through these next 10 weeks.

On the more "exciting" side, I have developed an allergic reaction from the new chemo drug – Taxol. It’s is a delayed one – it appeared 3 days post treatment during round one. A torso rash – looks like I have a pretty bad sunburn and it itches. Worried the bad reaction would keep me from round two, I was persistent to have my oncologist order higher doses of anti-histamines and promise that she’d come up with a plan for round two.

She did. Higher doses of steroids, along with anti-histamines to try and keep the allergic reaction at bay for round two. So far, it has worked. She also is in discussions with my insurance company to get approval to use an alternative drug to Taxol – Abraxane – which does not have the same adverse side effects as Taxol. The insurance company initially has DENIED her request - bastards. But neither of us is giving up. She has appealed and I have engaged assistance on my end to appeal as the “insured”. Anyone thinking this gal is just gonna take a “no” for an answer now, is sadly mistaken. And while I don’t like the idea of being hyped up on mega steroids for the next ten weeks – and my doctor isn’t thrilled about this either due to possible long-term effects - if I have to do so in order to get thru this, I will. Stay tuned for more on this one……

I received the results of my exhaustive genetic testing last week. As you recall, I was diagnosed with “triple negative" breast cancer. Approximately 10-20% of all breast cancers are diagnosed as triple negative. The triple negative refers to the three known “breast cancer receptors”: 1) estrogen 2) progesterone and 3) HER2. I did not test positive for any of these known receptors. Therefore, unlike patients who are positive to any or all of these receptors - drugs can be given to block the receptors as a course of treatment - the only course of treatment for me is chemotherapy.

Before testing, I was convinced I would find signs of why I have cancer – perhaps my genes would tell the story. Heredity. Perhaps the BRCA1 or BRCA2 gene. I almost hoped for a positive outcome in some ways just so that I would have some answers. But no. I tested negative for the entire exhaustive breast and gynecological genetic panels. A whole slew of genetic patterns examined for any sign of mutations, weirdness, strangeness….nothing.

As so here we are. I have cancer. No one knows why. There’s no known reason for any of it. What am I to do with that? I’m a person who likes things tied in bows. I search for the logistical, level-headed, reasonable answer for things. I helps to settle my mind. Gives me direction. A stated purpose for jotting a course. Instead, nothing. I may never know why I have cancer or if it will ever return. Because I don’t know what caused it. It keeps me up some nights. My mind races to find answers that just aren’t there.

Ten weeks to go in my chemotherapy. Seems like a long time to go – through June if I stay healthy and have no issues. To help the time go by, Liz and I have had several visitors stay with us over the course of my treatment to date. Along my brother (who remains my rock), and sisters-in-law (who planted an azalea garden for me!),

we've had and will have several old and faithful friends come stay with us and help out around the house and just be generally good company in the months to come. Along with a constant stream of seeing and hearing from folks, the short texts of just “thinking about you” mean so very much.   All of this has made a world of difference in my staying positive and forward thinking to when this ordeal is over and I’m once again cancer-free. It is a gift I cannot repay. Thank you.

Round Two - 12 Straight Weeks

I started my second round of chemo last Thursday. Twelve straight weeks of chemo. Utilizing a different drug than the first round of four treatments which were very other week. Daunting to think I have to go to the chemo room every week when it took me two weeks to feel half way human during the first round. But I'm told this next round is less stressful on your body: little to no nausea but fatigue and the threat of neuropathy (tingling of the hands and feet that unchecked could be permanent), along with the possibility of allergic reaction to the drug, on top of mind for the next 12 weeks.

My anxiety was made less having my brother in town for the week. He calms me and mows the yard - what more could you ask for.

The routine seemed similar. Arrived at the oncologist's office. Headed back to the chemo room signed in and picked a chair. Have my blood drawn and wait for the results. If my white and red blood cell counts are high enough, I can have the treatment. It's always the most stressful time. While I pay close attention to my diet and getting my rest, my counts are now in the "low" to lower than low range. Hopefully they don't fall too much farther.

My new chemotherapy drug is Taxol. Taxol is a member of chemotherapy drugs called plant alkaloids. Taxol is made from the bark of the Pacific Yew tree, who knew? And it works by inhibiting the dividing and replicating of fast-growing cells. As you will recall, cancer cells are hyper-fast dividing, thus are growing outta control.
The day of my chemo is always an apprehensive one for me. Just one rung higher than scared I'd say. I'm convinced this shit they are dripping into me is killing the cancer and saving my life, but knowing I'm going to chemo conjures up mixed feelings and emotions I try my best to keep at bay. And while I never want to "get use" to this, there was a routine, albeit a miserable one, created after the first eight weeks. Now with this new drug, comes new side effects, and a new routine (how long will I feel like shit, will I be nauseous, etc.).

My first concern was having an allergic reaction to this new drug. My worst nightmare (ok not my worst nightmare - cancer, hello?) but certainly a concern. The nurses - fully aware of this possibility- begin the transfusion of Taxol slowly. If you don't show any reaction, they turn up the volume. Thankfully, I breezed thru the ordeal and with the new drug on board and we headed for home.

Friday I felt almost 100%. No nausea, plenty of energy, ready to go! I had a good day hanging with my brother. We all went out for a Mexican dinner (Jeff had a margarita – I looked on with sadness). I couldn’t believe how good I felt! Saturday I woke up tired and sluggish. As the premeds of Thursday wore off, I became more and more tired, a bit depressed even. Poor Liz. She’s doing all she can to keep our home functioning as “normal” as possible and then I begin to break down. She’s a trooper at keeping me (and herself) going. Sunday was god-awful. I could barely move around. I’ve never experienced fatigue like that since Mt Everest (and that was due to the lack of oxygen in the air). I feared “this” would be my new normal for the next 12 weeks. Jesus.

Then Monday rolled around. Time to return to work. And my energy came back, along with an itchy rash. An apparent side-effect of the chemo. After a quick call to my doctor’s office, I’m on a course of anti-histamines until Thursday – when I return for another round of chemo. I sure hope the rash doesn’t prevent me from having my next treatment. Hard to bare delaying my 12 weeks in any way. I hoping she will pump me full of additional drugs to ward it off. More drugs.  Ugh. I’m like a walking medicine cabinet. While I’ve been able to put away the steroids and the anti-nausea meds necessary to get through the first round of chemo, I have replaced them with a more holistic regimen of vitamin B-6, B-12, and alpha-Lipoic acid supplements, along with weekly acupuncture – all centered around battling fatigue and any neuropathy symptoms.

Gawd. This is definitely a marathon. And not one I like participating in. I’m tired of feeling “off”, I’m tired of worrying “what if this doesn’t work” and “what if it comes back”, and I’m tired of relying on family and friends to do the most mundane tasks. However, I have gained a lot thru this journey. Seeing and hearing from old friends who I haven’t connected with in years has been priceless. Experiencing first-hand the beauty of human kindness and selflessness that reminds me that despite the ugliness of Cancer, the world is inherently generous and good. Thank you all for this lesson – it is one I will keep with me for the rest of my life.