Chemotherapy, Physical Therapy, Oncology and Cardiology.

Milwaukee Lakefront

I found myself facing another full week of doctors appointments leading to the tentative chemotherapy start date of March 12.  The first appointment would be on Monday – “chemo coaching”.  Monday also was the first day the temperature reached nearly 60 degrees.  Believe me, after this brutal winter of the polar vortex variety, it felt wonderful.  Those of you who live in Wisconsin know the implications of these warm, “teaser’ days in early spring.  You have to get out and enjoy any taste of warm, spring-like weather at every chance, because, if you pause, it will be gone.

I wasn’t going to miss it.  I headed straight for the beach.  I found the serenity and balance I needed while strolling up and down the lakefront.  It felt so good to take a first long walk after surgery.  The feel of fresh air filling my lungs, the sight of the beach in it’s strange transition from winter to spring; with ice flows and melting water creating rivers and waterfalls on the beach. To actually feel a touch of the sun on my face after such a long winter was delicious.  If I can balance myself like that every day, I might just sail through this…

When it was time for my appointment, I was fearing the stark contrast of the chemo ward to my calming beach experience.  Though, I quickly found a comfortable rapport with the staff, and the discussion of what is to come flowed easily.  All of my questions were answered, and I got a sense of the place.  It is quite comfortable.  I will have my own little curtain enclosed chemo-cave, complete with a reclining massage chair, roaming massage therapists, and cable TV, though I plan to bring books, music and audio books to pass the time.  I can bring a blanket and snacks and anything I need for the 4 hour treatment.  I can even have visitors, so if you’d like to help me pass the time, stop in and say hi.

Tuesday, I was sent to have an echocardiogram, because the chemo regimen I will be doing can be hard on the heart.  This was the most unpleasant experience.  Two and a half weeks post bilateral mastectomy is not the time to do this test.  It involves getting images and sounds from the heart via ultrasound.  What this entails is pressure, as the ultrasound wand jabs into my chest, ribs, and sternum to get angles on the heart.  It was excruciating. Thirty minutes of excruciating.  To add to the negativity of the experience, my friend had his cell phone stolen right from under our noses in the waiting room.  A woman came over and asked him to help her understand a paper she was reading.  He set the phone on our coats, took the paper, and helped her.  In return, she took his phone (his new phone, by the way).  Honestly?  Robbing someone in a hospital waiting room is a new low.  I hope she really needed that phone…

From there, we drove to Mequon to see the plastic surgeon for the first injection of saline into the tissue expanders.  This is a whole separate blog post in and of itself.  In a nutshell, the doctor uses a huge syringe to inject 100ccs of saline into the expander which is in place under my chest muscles.  The purpose of which is to expand (hence the name) the muscles, skin and tissue gradually so that, in the end, there will be room to perform a breast reconstruction.  I would compare the sensation to doing 5,000 pushups with bruised ribs, swollen tissue and stretched stitches; maybe. Though, I’ve never actually done that.

Tuesday night involved a pre-chemo margarita with some close friends.  Again, I’m taking all the breaks I can fit in to laugh and enjoy each day throughout this journey.  Besides, my “chemo-coach” gave the thumbs up to a pre-chemo margarita.  There was even some joking about making it a regular part of the preparation regimen.  I like this idea… Margaritas on a 20 day cycle, TAC chemo cocktail on a 21 day cycle.  I left Corazon (shout out to my favorite, little Riverwest restaurant) feeling happy, loved, and mentally prepared to take on chemotherapy.

Wednesday’s appointment schedule was packed.  It involve Physical Therapy (PT deserves its own post, as well), followed by a visit with the surgeon to get her thumbs up, blood draws, and the final meeting to get the go-ahead from the medical oncologist.  With that, chemotherapy was set to begin that afternoon.  They shuffled me around to these various appointments, and all was going well, all hurdles were being cleared…

…until the final hurdle with the oncologist.  Apparently, based on the echo, the oncologist wanted to postpone chemo until I could meet with a cardiologist to make sure that my heart could stand up to chemo.  Hmmmm.  This threw me.  I have always been really athletic and in pretty good shape.  My blood pressure has always been low, so I panicked a bit when I heard I needed to see a cardiologist.  Luckily, they got me in right away for a Thursday appointment.   The hardest part in all of this has been the waiting.  While waiting for information and answers, my mind naturally goes off thinking things it has no business thinking.

After adjusting my mind set to accommodate the change to my first day of chemotherapy, I now had the rest of Wednesday free.  Happily, that meant I could go to my kids’ parent teacher conferences.  It’s always good news at their school.  My kids do great at school and their teachers always love having them in their classes.  I got lots of hugs and support from other parents and teachers who are aware of my situation.  This conference was one of my proudest moments.  My 10 year olds’ teacher said some of the most positive and uplifting things about the strength she sees in Kaylei with all that she is struggling with.  Kaylei is a sensitive girl who does not like change. At. All.  Yet, she is taking this with such grace.  I couldn’t be more proud of both of my daughters.  They are so young, and have had to face some really difficult times, and they are doing well.  I am glad to have them on my team.  They are going to be tough forces in this life!

cards from school

Thursday, it was time to see the cardiologist to find out what kind of heart issue an active, healthy person could possibly have.  It turns out I have an ejection fraction of 52%, putting me in the low-normal range (normal bottoms out at 50%, but for TAC chemo, they like to see 55%).  What does that mean?  Ejection fraction represents the volumetric fraction of blood pumped out of the left and right ventricle with each heartbeat. What I took away from the description is that my healthy, active heart works so efficiently that it functions smoothly without having to work too hard.  That sounds like a good thing.  The problem is that the chemo will be an additional strain on my heart, and they want those numbers up.  The cardiologist prescribed a medication that will increase my heartbeat, and the volume my heart puts out, and cleared me for TAC chemo.  My heart will need to be further monitored during chemo, meaning more echocardiograms… Yay!

Friday, back for PT.  From there, I went to the Vince Lombardi Cancer Clinic to find out when I would begin chemo now that all of the additional hurdles were cleared.  All set to start, again, this Tuesday, March 18th.

Mental preparations will continue this weekend.  I got in some roller derby last night (spectating, not participating.  Thank goodness, because there were ambulance calls on the floor this time…).  Tomorrow is the big day for hair cutting, decorating and coloring with the kids!  And then, Milwaukee, I have a St. Patrick’s Day to tend to before Tuesday.  Friends, where are we celebrating?