Tag Archives: Chemotherapy

Contingency Plans

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Little by little I am starting to get a sense of where this treatment plan is going. Baby steps.

I saw my oncologist, Dr. Robison, early this morning before chemo. I had approached this check-up with no expectations. Quite frankly I just assumed it would be a quickie visit: Listen to lungs, feel my belly, take notes on the extent of the side effects, girl talk for a bit, then send me on my way. I was partly right but we did have a productive conversation about future treatment.

In more recent previous posts I had talked a little bit about the frustration I was feeling over not feeling like I was progressing. There is no finish line, no end date, no goal to strive for other than keeping my chin up and staying the course. After my visit with Dr. Robison I left feeling relieved and at ease with what may come even though it is still very uncertain.

I am generally a planner. I like to have an idea of what is to come. With that in mind, I am also fairly adaptable and as long as some sort of plan is in place I can roll with that plan being altered. Bottom line, I do not want to feel stuck or stagnant.

We spoke openly about what tricks she may have up her sleeve for me in the event that the Taxol/Avastin combination is no longer best the course of treatment. In a nutshell this is a tentative plan of attack:

Scenario #1: We take a CA-125 bloodtest next week and the results show a decrease

  • Stay the course with Taxol/Avastin.

Scenario #2: We take a CA-125 blood test next week and the results are unchanged/slightly increase (ex: by 20 or so)

  • Still stable, stay the course with Taxol/Avastin.

Scenario #3: We take a CA-125 blood test next week and the results increase by about 50 or more –> Conduct a CT scan to get a visual on what is actually happening. Is the disease unchanged or progressive?

  • If we do a CT scan and the imaging shows that the tumors are unchanged and there is no new progressive disease we would be inclined to still stay the course with Taxol/Avastin as stable (no new growth = good)
  • If we do a CT scan and the imaging shows progressive disease (new tumors/growth) we may move to a different type of chemotherapy called Doxil.

So what is Doxil you ask?

Doxil is a platinum based chemotherapy called an anthracycline used commonly in recurring low grade ovarian cancer. The American Cancer Society was kind enough to explain this online in plain English for me. This just means that the drug targets enzymes involved in the replication of DNA. Its job is to destroy the cancer cells formed by the botched DNA. Like Taxol, it is not exactly a targeted therapy so it can also destroy normal tissue. One of the benefits of this drug is that it stays in your system a little longer because it is designed to go almost undetected by the immune system. This allows the drug more time to do its job. Or so I read…I am no means an expert on this drug aside from a basic google search.

Based on what I have been told by Dr. Robison and Rosa, my nurse, Doxil is also pretty tolerable. The most common side effects are skin rash (tinging/burning/flaking of the skin on palms of hands and bottoms of feet) and mouth sores. These side effects worry me because I have had variations of both in the past and it is not pleasant. BUT there are always risks with any medication.

IF we decided that a switch to Doxil would be the next step, and it may not need to be, the infusions would only last about an hour once per month. The only other downside is that I would need to be the most patient patient. I was told that they do not typically see any immediate impact on the tumor marker for the first few cycles. It would be another exercise in trust.

The other option that I inquired about is immunotherapy since it is being discussed at length in health media as of late. There is an immunotherapy trial going on at WIH currently but Dr. Robison did not feel that this particular trial is my best next step just yet. She is not ruling it out for the future if it is appropriate for my circumstances down the line.

A lot of information to take in, right? Remember, the plan may not even change! I am just relieved to know what my options are and how I can mentally/physically prepare for what is to come. I really appreciate that my doctor is always one step ahead of me, keeps me informed, doesn’t dismiss my concerns, and is honest with me. That is so important in a doctor/patient relationship.

After the appointment I headed over to the infusion center to see my girl Rosa for Taxol. One of my cancer crushing buddies was kind enough to come by with a HALF DOZEN Allie’s Donuts. If you are from the Rhode Island area- you know what I’m talking about. It’s sugar crack amazing heaven in a box.

Thank you for the visit and treats Jocelyne!

All in all I am feeling ready to move forward no matter what is to come. I find comfort in knowing I have options. Stay tuned for my create your own cancer adventure as we will know more next week.

“…good news and bad news are often relative to your expectations”

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*Dramatic SIGH* I won’t lie to you friends, I have been having a tough couple of weeks. Part physical, part emotional, there has been a fair bit of annoyances/disappointments to process. Yesterday I went in for my weekly treatment. This … Continue reading →

“She is BALD, Jerry”

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I will preface this entry by saying that I am fresh off of chemo this morning and still feeling the Benadryl haze. I typically try not write the same day I receive chemo. My fear is perceiving that I am … Continue reading →

“Your stars will realign and things will get a little bit better”

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I read this article in Cosmopolitan a few days ago (thanks Mom!): I Have Cancer…And It Sucks by 25-year old Deanna Pai, Cosmo Beauty Editor. Go ahead, it’s a quick read. I’ll wait… Crib notes for lazy bones: Deanna is young, has … Continue reading →

Chemo & a Canine

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My life has taken an interesting turn in the past week. Last week, I wrote about adopting little (big) four-legged furball named Josie. The past week together has been exciting, heart warming, and challenging all at the same time. Josie is a very special pup and I can see why the foster coordinator at Big Fluffy Dog Rescue and her foster mom were so enamoured with her. josiegirl

She looks deeply into your eyes (and possibly into your soul) with such love and purity it is hard not to melt looking at that face. She had such a tough life leading up to being brought into Big Fluffy, I am shocked that this sweet girl can still love and trust so deeply.

Truth be told there have been a few times over the past week where I felt a little overwhelmed/stressed but generally her transition has been good.

Funny story about a particularly challenging evening:

Cory was concerned that she would drag me down the street on walks due to her size in comparison to my size (she weighs about 45 lbs. and I am clocking in at about 100 these days. THAT’S right! I finally tipped the scale!) I can handle a 45 lb. dog but when she is pulling and lunging at small dogs, cats, bikes, and squirrels, it takes some manpower to keep her in check. So on a night where she was particularly overstimulated, I figured I would try and burn off some energy by jogging with her on our last outing of the night. Imagine us in the streets of Providence off of Broadway. We’re running at a pretty decent pace, and I think to myself, “I’m totally going to tucker this girl out, I’m a geni-HOLY SHIT!” Suddenly, I hear a large German Shepherd bark behind a chain link fence to our left and Josie comes to an immediate dead stop. In that moment I run full force into my goddamn dog, trip over her, and land flat on the pavement, hard. It turns out that my demise ended up being my stationary dog acting like a speed bump.

On the bright side, Cory was wrong about this particular concern…

Yes, yes I am. Sorry your honor.

Anyway, this mishap aside, Josie has been pretty great even when I’m at work for the day. I mean, if you left me with a cozy bed and AC all day I’d be pretty psyched too.

There are dog mama perks aside from all of the awesome puppy snuggles and kisses I get everyday. In taking care of Josie it has forced me to be more purposeful with my time and provide better care for both of us. Now I’m not saying every cancer patient should run out and get a dog. Trust me, just a few months ago I was NOT in a place where I was up to this. I will say though, she has nudged me to make some positive changes in my daily routine. Not only do I take lots of walks, but I soak in my neighborhood and the people in it. I wake up earlier, plan mealtime better, and thoroughly clean everyday (she sheds like a fur monster. Thank goodness she doesn’t go on the bed and couch).

This routine has oddly given me energy even though I’m putting in more “work”. I think that these factors can only aid my recovery. Plus that unconditional love and care is just plain good for morale.

Now onto the chemo nitty-gritty.

I am going into my fourth cycle of Taxol/Avastin. Friday of this week will be the longer day where I get both drugs. It has been generally tolerable but I am seeing some annoying side effects start to creep in more and more:

  • Hair loss- No surprise here. I would have thought that I would have shaved by now but the back of my head is still full, it’s just the front that is mega thin. With some strategic combing and headband placement I have been able to dodge the razor for the time being.
  • Dulled taste buds- I am not experiencing the metallic taste that some other patients describe but food last lost it’s luster. I can taste food but everything is much more bland. I find myself gravitating toward stronger flavors and spices than before so I can really enjoy what I’m eating. My appetite is great though!
  • Hand rash- I have a rash on my hands that itches like crazy constantly. Any other cancer crushers out there experiencing this from Taxol? Use, Hydrocortisone cream and cool compresses. It helps although nothing but tapering off the Taxol will make it go away.
  • Sore fingernails- I’m not even kidding. This is actually a thing. My nail beds feel constantly inflamed. After all this time you’d think I would stop googling my medical concerns. All I found were horror stories about people’s nails falling off during/after cancer treatment. So help me I will STAPLE my nails to my fingers if I have to. (Not to worry, my nails are intact). I’ll just deal with it.

This list of complaints in comparison to my list of complaints from previous treatments is nothing. This is living the good life! I’ll take sore finger nails and bland food any day over a daily ride on the puke train.

I can safely say that I’m pretty happy right now. Things will only keep getting better, I’m sure of it.

We are keeping the positive energy going as I get my weekly blood work done tomorrow. It’s a CA-125 week so I’ll be getting an update on my tumor marker Friday.

bigmoneynowhammy

Everyone Loves a Good Comeback Story

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Week 4-5 of treatment has brought about some excitement. I’m riding the wave of what I would call an upswing.

If you just want a quick “how is chemo going?” you can scroll down to item #4 the bottom. I have a feeling that this one might be a novel but too many great moments went down:

1.) Bryant University’s Class of 2015 Commencement:

The week leading up to commencement is interesting, calm and mildly nerve wracking all at the same time. We clear our calendars and take no appointments (except emergencies). Our front desk staff diligently works with Academic Records as grades pour in to print degree audits for every single senior. Us, the advisors, pick our favorite Pandora stations and hunker down in our offices reviewing every degree audit line by line to ensure all degree components are met. Every ‘T’ crossed and every ‘I’ dotted. Normally I keep my Pandora pretty vanilla for office purposes, Indie-Singer Songwriter perhaps, but not this time. Oh no- to get through this week I needed coffee and some serious hip hop jams. Childish Gambino and Atmosphere amongst others put me in the zone, seniors got certified, no mistakes (that I know of) were found, and I could go home relieved.

The real excitement took place on commencement day. I knew it would be a proud day to see these students that have evolved personally and academically. What I didn’t anticipate was crying about seven goddamn times! One of my advisees, Emily, was the first to open the floodgates by handing me a gift before she lined up for the procession:

emilygradbouquetbouquetletter

There is a backstory to this but in a nutshell Emily has been telling me for two straight years that on her graduation day she would give me me a bouquet of flowers made of her statistics homework because the course gave her (and subsequently me) so much grief. She delivered on that promise and I LOST IT. Emily is just one of many students that day for whom I was sad to see go.

To put it in perspective for the purposes of this blog, I’ve known this particular class of students for as long as I have been sick. Through surgeries, hospitalizations, and physically/mentally taxing treatment plans I have balanced holding it together to serve this student population to the best of my ability. One must question occasionally, am I still able to do this job well in the midst of ongoing life challenges? (My director is probably banging his head against his desk reading this because he assures me, almost daily, that I am doing good work.) But for the students who may or may not know what is going on in regard to my health, it is beyond reassuring to have moments like this where you know that against all odds you made a meaningful impact in the job that you do, sick or otherwise. This gesture held many dimensions of meaning for me personally and professionally.

2.) Sara’s Bachelorette Party:

After a box of Kleenex and a beautiful commencement ceremony I headed over to Foxwoods Casino for my cousin’s bachelorette party! One of the highlights of my weekend. We had a super hilarious group of girls and despite not feeling my best around 11pm I was still able to hang for a good portion of the night before heading back to the hotel early.

Here she is, the beautiful bride to be:

saramebachelorette

As you may know I have a VERY small family so Sara is one of my few cousins and she means the world to me. It seems like yesterday that we were chasing eachother around my grandparent’s basement at Hanukkah parties as my brother taunted her for her admirable aspirations of someday operating a school bus (spoiler alert: she became a teacher sooo…close enough). Now as an adult, Sara is still the same amazing person with a gigantic heart of gold. It is truly an honor to share these moments and to celebrate one of the most supportive and loving people in my life.

Any and all other details of the bachelorette party remain at Foxwoods, sorry folks.

3.) Prevention Magazine:

Recently, a childhood friend approached me about writing a story about what it is like to be on a clinical trial that she would pitch to Prevention. The talented Kristen Domonell did a wonderful job! She certainly maintained the integrity of my personal story and provided a balanced viewpoint. It is an “as told to” style so it was written by Kristen but told from my perspective. You can check it out here: http://www.prevention.com/health/cancer-clinical-trial

Having this published made me pretty giddy. Storytelling creates community and understanding! I hope by putting this story out there at least one other reader could relate.

4.) Chemo Update:

I just finished my first full cycle and started a 2nd last Friday. Just as I have been reporting, I am tolerating this treatment well. I’m still gorging myself with food and sleeping well. The only minor side effects that I’m noticing are occasional nosebleeds (result of Avastin) and I’m finding more hair in my brush and sink than before. The hair loss isn’t remotely noticeable to anyone else just yet but it’s definitely starting.

This past infusion I was accompanied by the lovely, witty, Stacey Goldman! We were fortunate (again) to get a private room with a bed AND a recliner. As a result, Stack and I spent our time there watching bad daytime tv and taking nappies.

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We did tack on an extra hour to treatment because my port was for lack of a scientific term, “gunked up”. The heparin flush went through but my nurse couldn’t get a blood return so they had to give me tPA (Tissue Plasminogen Activator). Think of my port as a clogged sink and tPA as the ‘Drano’ equivalent and there you have it. Once the tPA did its job we were able to get a blood return and get back to business.

While we were there we received a positive update from the infamous Sheila, nurse navigator. I have weekly blood tests and she was excited to share with me the results of the CA-125 tumor marker. So excited in fact, she texted my results followed by: “I told Rosa to tell you what your tumor marker was but I’m just so excited about it I’m texting you now…She’s going to tell you so act surprised!”

My CA-125 is currently 2190. Which if you recall from other entries about the CA-125 is not actually good at all. A safe or preferred CA-125 is generally under 21 (or 35 depending on the hospital). Obviously, mine is a skosh higher than 21. What makes this news exciting is that when I started this treatment 3 weeks prior to the blood test, it was over 4000. This means in a single cycle my tumor marker has reduced by about 50%. HOLY SHIT. Something is working. I hope I don’t eat my words later but honestly, I just have strong positive feelings about this.

Naturally, to celebrate Stack and I indulged in the first Eskimo King visit of the year. Lavender soft serve in a waffle cone with rainbow sprinkles. I’m pretty sure in the midst of getting it all over my face and clothes like a child, it also seeped into my soul and made it smile.

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Cheers to continued improved health, happiness, and well-being!

Cycle #1- Donezo

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Oh hey there friends! As of this past Friday I have completed my first full cycle of the new treatment. Each full cycle is three weeks of treatment: Week #1: Avastin & Taxol (3-4 hour infusion) Week #2: Taxol Only (2 … Continue reading →

So far, so good

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Hello there friends, so we are 2/3 of the way through my first cycle of chemo. This week was even easier than last week’s infusion since it was roughly 2 hours shorter. Gone are the days of 9 hour infusions, THANK YOU LAWD.

This week I was infused with Taxol only. Taxol is the drug that I am receiving weekly. Taxol is the weekly chemo part of this dynamic duo while the other is an antibody received on the first day of every three week cycle. Last week I only felt crummy on Sunday and had some mild stomach “yuck” but aside from that I was generally okay. I do anticipate a cumulative effect where I may grow a bit more fatigued or worn out over time but so far, so good.

Yesterday’s infusion consisted of about 45 minutes of IV a pre-drugs: Zantac, Steroids, and my personal favorite- Benadryl. The steroids would explain why I feel like a million bucks the day after treatment. I wished the lasted a little longer, I could probably climb Kilimanjaro with the energy it gives me. Mom and Dad stayed with me until the Benadryl started to take me into nappy dreamland. They kindly used the next hour to go to my apartment and clean for me! What gems. I mean, how did I get so lucky? There is nothing like coming home to sparking floors and countertops especially when performed with such love. Thanks Mom and Dad! After an hour of Taxol we were all done. In and out in no time.

Today I woke up feeling pretty good. So far I’ve treated myself to breakfast at the Wayland Diner and stuffed my face with eggs, fruit, toast and turkey bacon. On that note I have been absolutely RAVENOUS in the past week or so. My appetite found its way home! The thought of food for the better part of the last year made me physically ill and eating it also made me physically ill…hence my current double digit weight. I’m still within my BMI but really cutting it close on the lower end. That being said I’m bulking for bikini season. No one needs to see skeletor at the beach. I’m sure that my nutritionist will be quite pleased to hear that I’m happily shoving all sorts of foods down my pie hole.

741-Feed-me

When my doctor was researching treatment options for me she was very fixated on creating a much better quality of life than what I’ve had in the past. I honestly get a little choked up as I reflect on this because even though it’s only been a week I already see a vast difference in how I feel both physically and emotionally. This past year was plagued by constant illness and depression and this spring has opened a much more optimistic chapter. I finally feel like I have the ability to be well. For a while I became pretty jaded and lost the hope that I was capable of going into remission. I can’t fully explain why but I’ve restored my faith in this process. Even though it’s still a shitty thing to have to experience, it’s somehow better. I have high hopes that in a few months when we look at my next scan that we will see some progress.

I’m going to wrap this up with a couple shout outs:

Happy 30th birthday to the beautiful, talented, sassy, amazing, best nurse-navigator that ever lived- Sheila Enderby! I hope you enjoyed your party and amazing Prince cake.

princecake

Happy birthday also goes out to a beautiful nugget that I have yet to meet- Karly Jae born yesterday to proud parents Joanna and Kyle. You are going to be amazing parents to this little girl! (If you need a break Uncle Cory, Uncle Sam, Auntie Alicia, Uncle Hudson and I will totally babysit and spoil the crap out of her)

Enjoy your weekends everyone!

All systems go: A new treatment plan in motion

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What a day, nay- what a week.

At work we are in the midst of the course registration frenzy. During this time there are a lot of time sensitive concerns, a high volume of varying needs, and general stress. On top of that all I can think about all week is:

1.) I need to stop hacking a lung or I might turn myself inside out.

2.) What treatment plan will provide for me the best quality of life

3.) Pizza (because pizza is usually at the forefront of my mind).

My supervisors and colleagues have been very sensitive to my recent and ongoing challenges and stepped up in a huge way to ensure that I could rest my body and ease my mind. I didn’t realize just how necessary it was to just decompress until I got home, got into bed, and felt all my insides just ache.

STILL Fixing a Broken Squeaker:

Today was a big day. First of all, the coughing has gotten out of hand and although I had some relief after the thoracentesis, I underwent a second this morning. After performing an ultrasound on both lungs they determined that the left side was STILL worse than the right side and they again drained from the left side.

No Farva, that’s not Liter-Cola, it’s another full liter of my tumor juice.

wpid-20150417_101352.jpglitercola

Sheila, my now fancy nurse-navigator, was a doll and went with me to observe the procedure and wiped the tears from my eyes and goopy nose while I periodically whimpered. The PA that performed the procedure was VERY good and although it was still a difficult procedure to endure, it wasn’t as traumatizing as the first time.

There is still some fluid boppin’ around in there but I can certainly breathe even better now. Slowly, we’re making progress. I just pray to the good heavens above that I don’t have to have this procedure done again anytime soon. Two in one week is enough torture.

The Treatment Plan:

Prior to draining the pleural effusion from my chest, I met with Dr. Robison to carefully weigh out all of the treatment options we have in front us. After great consideration, we agreed that we would try pairing Avastin (an antibody) and Taxol (a commonly used chemotherapy that I’ve had previously). There is research to suggest that Avastin in combination with Taxol yields more promising results than Avastin alone. The decision to start with a chemo-combination as opposed to Avastin on its own was also heavily influenced by the amount of fluid that has been collecting in my chest. The Taxol should do a good job of drying that up. Eventually we will be able to taper off the chemo and only use Avastin. I do not have a timeline for this.

The up-sides:

  • Will provide good quality of life
  • Minimal side effects
  • I DON’T have to take it at home (it will be an outpatient infusion)
  • Treatment will occur at Women and Infant’s in Providence (less than a mile from my apartment)
  • I already know that I tolerate Taxol well

Moderate-Bummers:

  • At least for the first few months I will need infusions once per week (still not as bad as the first time)
  • I may lose my hair again. But even so- I know I have a nice round head and in the grand scheme of things feeling well trumps having hair.

With all of that being said we are wasting no time! My first treatment begins next Friday and I plan to be there with the ever handsome and delightful Cory Tysoe. Little does he know that he will just have to just watch me pass the eff out once they toss some Benedryl in the IV (Benedryl naps for life!). Cory- you should probably bring a book…

So in short, it’s been a BIG week of mixed experiences and emotions but I’m still full of fire and will do everything I can to claim my life as my own and NOT cancer’s chew toy.

Mom, Dad, Adam, Cory, family, and friends (I’d be typing names for decades, sorry). Thank you for always having my back, always believing in my ability to be well, and helping me to navigate and endure the ups and downs of this disease.

So much gratitude…

Jess

Questioning Quality of Life

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I haven’t written since the end of February…yikes.

Where we left off was with my unhappy guts. I had another consult with the gastroenterologist and she decided that although the x-ray showed no sign of lingering obstruction, it was not safe to perform a colonoscopy. The team at Mass General seemed satisfied with her professional opinion and it was agreed that we would forget about it for now.

Coming down the pike is a CT scan on April 1st. On April 7th my parents and I will be heading to Boston to find out my scan results and talk about my treatment moving forward. Regardless of what the scan results are, good, bad, or unchanged, I am requesting my final dose reduction. I am allowed one more and I’m running with it.

Since the last dose reduction nothing has changed. The side effects are nagging and constant. I have bottles upon bottles of medications to combat the side effects of this treatment and I am just left swimming in pills.By the standards of the drug company the side effects are “tolerable” but we all have our limits. This is not how I want to care for myself. Each day has been a struggle and I’m worn out.

I actually just sent an email to the medical team at MGH expressing my concerns and requested a dose reduction for consideration. The principal investigator of the study emailed me back 12 minutes later (on a Sunday night no less, that’s commitment!) and he was understanding of my concerns. He said that there is no sense pushing through this dosage with a crummy quality of life and that he would speak to the team and get back to me.

I am also setting up a consult with my homegirl Dr. Robison in Providence to discuss alternative options should the time come that I choose this study is no longer right for me. She also emailed me back right away (again, on a weekend!) and kindly agreed to meet with me after my CT scan to discuss other kinds of treatments that might be a little easier on me.

Quality of life is far too important to ignore. I do not know what my future holds with this treatment but I am determined to reignite the fire I had within me when this all started in 2012.

To start, I’ve decided to adopt The Unbreakable Kimmy Schmidt’s quirky theme song as my own:

Thank you Netflix binge and my hero, Tina Fey, for this delicious find.

Lastly, please send some positive and healing vibes to a friend of mine facing a recent cancer recurrence. Her name is Elyse, she’s a ball of excitement, and she is a cancer fighting BEAST. I had the pleasure of meeting her last April at the Stupid Cancer Conference in Vegas (and 24 hours later held her hand as she fearlessly got her first tattoo at the Hard Rock). She is all about pumping up those around her so it’s time for her to receive the same positive energy. #WorkItOut Elyse!

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elyse

(Photo Credits: Dan Shapiro)