Lump n Bump

I got my report card today. It was surprising.

Every day of chemo treatment starts the same. (I’ll walk you through it so its nice and light, and not too severe triggers for medical phobias- you’ll be ok Jamie). You first get weighed on a scale so that any concoction is specifically calibrated to your body today. You can pick a chair next. I look for one that reclines easily, and is paired with a good pump stand with good wheels. That’s important for the five trips I make to stretch and pee.

Second is waiting your turn for a blood draw. Its very nice and easy for me, my port makes sure of that. There’s a numbing cream I can use to make it even easier. There’s just one poke and then I get the dangly tube taped on to my shirt and I’m good to go for my 6-7 hour work day and built-in nap.

Once the complete blood count comes back good, I can settle in. I’ve never been turned away for chemo for having too low of an immune system, but I’ve seen fellow patients denied treatment because it would not have been safe to further damage their body. The main thing that nurses, PAs, and doctors are looking at to determine the course of treatment is the red blood count, hemoglobin, white blood count, and the ANC.

These are the metrics I use to evaluate how my body is coping with the chemotherapy day-to-day. These blood counts impact how I feel while I play with George or eat dinner or wake up in the morning or decide to go home to rest. Low red blood count doesn’t really do anything for me; I started this journey anemic, I was slightly anemic every time I’ve got bloodwork. Low RBC is my normal. Low hemoglobin though, boy howdy, that’s when Brianna goes to the ER to vampire some donated blood. Low white blood count is my experience for all of September; it took me three weeks to fight off the headcold that George gave me, and three more weeks to stop coughing mucus hourly. Low ANC is hard for me to detect, I’ve not pinpointed what that experience is like, which makes me nervous to find out definitively. I suppose it might be similar to the low white blood count, since they’re both cells that fight infections.

• I take an iron supplement to boost my hemoglobin and red blood count. I’ve felt much better since I started taking extra iron a week an a half ago. I also notice I bruise again! (I wasn’t doing that for a while, I did’t think that was too good)
• I wear a mask at work to reduce my risk of exposure to infection and protect my white blood count.
• St. Jude’s website explains ANC as “The absolute neutrophil count (ANC) is an estimate of the body’s ability to fight infections, especially bacterial infections.” If you have low ANC, you don’t get chemo; you get other drugs to boost your ANC and ability to fight infections. I take a Vitamin B complex supplement and eat dairy and eggs as an effort to boost the ANC.

The ANC has been very unpredictable since I started Taxol. I was low when I went to the ER and got a blood transfusion. The donor blood had some good neutrophils and hemoglobin, and I used them. Then it was down September 26 for the first Taxol. The Friday after the first Taxol it was up again. Then it climbed on October 3rd. On October 10th, it crashed in a nose-dive fashion. My count was very low, and we got nervous because Neupogen shots (used to boost ANC) are not an option if I want to stay on schedule. But today my ANC was off the charts! Literally, higher than the normal range. I asked my nurse if she could double check it and run it past my PA or doctor too. We finally put together that the prednisone steroid was boosting my neutrophils, and I think I might just now be getting the last of the phlegm out of my chest from the cold in September. That’s why my report card was surprising.

So with the report card analyzed and my weight calculated the nursing staff can bring me my personalized bouquet of IV medicines in little baggies. They come labeled with my name and birthdate so that I always get the right doses for me. I get IV hydration to perk me up; 90 minutes. I get prednisone as a steroid to help my body tolerate the chemo; 25 minutes. I get IV Pepcid to help with nausea; 17 minutes. I get IV Benadryl to make sure I don’t get an allergic reaction to chemo, it puts me right to sleep; 35 minutes. Then I have a 20 minute saline flush to make sure the premeds are out of the IV tubing and all working inside me. All together, the pre-meds take hours. It’s usually 1:30 or 2:00 PM before I even get to the chemo; I arrive at 9 AM.

Throughout this time, I snack, I drink water, I scroll Facebook, I walk around with my pump pole, I call doctors and make appointments, I shop online, I eat lunch, I sometimes text with my coworkers about events and solve problems. Most times I embroider onesies, but I didn’t feel like it today. I chat with neighbors and nurses too, at least until the Benadryl kicks in.

After all that, we can start on Taxol. I’m usually dozing, and they wake me to have me confirm my birthday- to make sure the right baggie is hooked up to me. This infusion takes 90 minutes. I sleep through it, and stir only to peel off layers of hats scarves and blankets.

After chemo, my nurses take a blood pressure and ask me if I feel okay. I almost always do. One time I felt hot and dizzy- that was after Adriamycin/Cytoxan. We fixed it with Tylenol. After Taxol, I am always hot and sweaty, but that’s normal I suppose- no one offers anything more than a shrug and nod and a sympathetic “yeah.” I’m also far too groggy to feel or articulate anything at all.

Funny story today, just as the Benadryl was hitting, I was getting a breathing treatment. The nebulizer (air pump) was on a cart that also had other equipment. Like an AED. from where I was seated, I thought the AED doubled as a nebulizer. When the breathing treatment ran out of juice, I pressed the only on/off button that I could see. The AED started telling me to remain calm. I was mildly surprised to hear a breathing treatment speaking voice commands to me, but I’m basically drunk on Benadryl, so I was like, “bet, I’m calm.” Then I saw the nebulizer’s off switch and dimly realized I’d activated the automatic defibrillator. Cathy the nurse came up behind me and turned off the defibrillator and said that we don’t need that excitement today. I apologized for being the dramatic patient, and sat down quietly for my nap after nodding in apology to everyone. So that was a funny short-lived moment of embarrassment that I share so you may chuckle at my expense instead of cry.

But all of this is to confirm that I will carry my daughter to full term of 37+ weeks while I finish twelve rounds of Taxol. Also, the tumor is undetectable through my skin. I don’t feel it at all anymore. Nor does the professional. Go team lump.

I made an appointment with my surgeon to get some scans and plans for surgery. My mom’s coming to that appointment with Nick and I, Dr. Peyser was her lumpectomy surgeon too. I thought it could be nice to have a personal survivor in the room when Dr. Peyser learns how well I’ve done on chemo.

This week I meet with team baby bump and confirm that the delivery comes as late as possible. I get chemo until mid-December, then I rest and recover to have a baby! I also want to learn more information about C sections this week. I don’t think its the right option for me, but I want team baby to know that I understand if its life or death, I choose life. Birth Plan vs Birth Wishlist.

Everything is going according to plan, and the high I have from this accomplishment is no small thing. It feels like soaring. I thank everyone for reading, supporting, donating, praying, taking care of George and Nick and one another. Realize that you are grateful too, even with all of the trials you have in your life. You can still be grateful and amazed that you and I are okay right now.