January 20, 2012: A Funny Thing Happened on My Way to Being a Model Chemo Babe...OR Living a Chemo Fear

On Friday (January, 20th), this blog entry was going to be called "So what do Cancer Babes do on their Friday nights.......". Well, what we thought might be a one night episode has taken a life of its own and is not over yet (and will be continued in other entries).  So hang onto your boots, the bumpy, bumpy ride has started! (with tons of gory details that keep unfolding...)

To bring the right color to this picture, I'll start from the beginning.  The beginning was where my previous blog entry ended -- my first day of chemo was a glowing success.  In fact, the next 8 days were really great, little to no nausea, food did not taste too bad, I was only really fatigued on day four, went for walks every day, went to a yoga class, cooked, baked, spent with time boys, drove the boys around, started a de-cluttering project and kept my hair.  The walks were great with a variety of great walking partners including my hiking guide, Angela, who, with me, Sophie (her dog) and sometimes Todd in tow, took us up Burnaby Mountain through various routes that ranged in intensity and lasted between an hour to an hour and a half.  I was starting to envision setting a chemo record of walking every day of the journey and even getting into some kind of shape by the end of this thing! (NOTE: the walking started as soon as I could after my last surgery, with more walking partners, so this was a strong continuation of the effort.)

NOTE: Exercise can prevent so many nasty ailments so if you are not exercising now, get off your duff and go.  The youtube link came from my sister who is a Kinesiologist/Personal Trainer/Rehab Specialist.  The message is simple and powerful:

http://www.youtube.com/watch?v=aUaInS6HIGo&feature=youtube_gdata_player

As my sister, Shirley, Lisa, Angela and others know I am no stranger to rehabbing my body after having kids.  Exercise and supporting disciplines like personal trainers, physiotherapy, massage therapy, acupuncture are all great things to keep the bod healthy and to prevent a ton of nasties. Even though I have cancer, it will not stop me from believing in living healthy physically, mentally and through diet.

I digress….For more clarity, while on the type of chemo that I am on (which is a 21 day cycle or every three weeks), the following (and more) is generally expected:

·         Days 1- 3ish: largest impact of nausea - I sailed through that par

·         Days 7-10: expected nose dive of white blood cell count to start and immunity compromised - on days 7, 8, 9 and prior I had lots of energy with the exception of day 4. Day 10 is when the problems started and will be described in gory details below

·         Days approx 19-21: white blood cell count should back or close to normal to prepare for next round

·         Weeks 2-4: hair loss to start - I was doing pretty good in this department, until today,  January 25th (two weeks on the nose, I am experiencing more hair loss than normal, but I still have lots of hair to go before we pull out the old hair razor and give my head the old brush cut...)

So day 10 arrived. I got up with the boys and felt good.  I got my day going, continued on my de-cluttering project (going through ALL of the loose toys around the house, organizing them and then figuring out what to do with them, I was pretty proud that I still know the difference between Lego and Bionicle parts, Kinects, Pokemon, Yugeo, game pieces, etc, etc, etc, etc..).  I was looking forward to lunch and my regular afternoon walk.

At 12:30 pm, while basking in all the toys parts, I started feeling a blunt, but persistent and noticeable pain where my left breast used to be (mid chest near my chest bone and near the tissue expander -- yes the fake way to grow a breast).  I didn't think too much about it as I have had many wild and wonderful sensations with the overall experience to this point.  The pain then started to travel a little towards my shoulder, but there was no sign of infection (ie increasing warmth or readiness in the area and I did not have a fever).  I was getting a bit more concerned as I started to get a little chilled and tired.  I figured a good lay down would do the trick and I would be ready to go through the rest of the day.

Well, once I was down, I was down.  I got more and more chilled and just could not get warm, however I had no real fever until about 2:00pm when it reached 99.4 degrees F.  I finally  started feeling warm at 4:00pm after lying in bed with all my clothes on, all my bedclothes, using an electric heating pad and having my temperature climb to 100.4 degrees F.  By 5:00pm my temperature went 101.2 degrees F and by 6:00pm it went all the way to 102.9 degrees F.  In between all this burning love, there is a strict protocol that we cancer babes need follow.  If our temperature rises between 100.4 - 101.1 degrees F and stays within this range or greater than an hour we are get a hold of our oncologist to review the symptoms (as there can be more than just a fever) or go straight our nearest Hospital emergency.  

Wouldn't you know that all this peaked just after office hours for my oncologist and all my regular doctors on a Friday night-- Murphy's law at it again.  So the first line of defense was to contact the on call oncologist to review the situation.  This process went pretty smoothly where we got a hold of Dr. Lee who seemed competent and nice.  She agreed we were at the right stage to truck on over to emerge.  Into high gear we went with arranging for dinner for the boys with my parents and getting Marc's and Lisa's help to get Iain to his Friday night basketball game after that.  With this all arranged, Todd and I were off to emerge at Eagle Ridge Hospital.  By getting Dr. Lee on our side, she was able to call ahead and let the emerge staff know that we were on our way.  This part of the protocol is not so I am pampered, but to ensure that I am not exposed to high germ traffic areas for too long in the hospital or where I can give more of my own and so that I can be evaluated as quickly as possible due to my compromised immune system.

The process worked beautifully.  I was admitted almost immediately where the details of  the situation were gathered, vitals acquired and an intravenous started (took two tries -- there will be a definite poking theme through this experience).  Once the emerge doctor (Dr. Street) was able to evaluate the situation, he ordered a chest X-Ray to make sure there were no nasties in my heart and lungs, blood work that included checking my white blood cell count and checking for infection/bacteria and a urine sample to test for infection/bacteria.  I was finally able to take Tylenol to start addressing the fever now that I was under medical care and evaluation so masking the fever was approved.

The result of all this (and three pokes later), was that my white blood cell count was low (which was totally expected based on the chemo drugs I am on), but they were within a tolerable range (my cell count was 1.6 where normal is 4).  The on call oncologist's advice was not to prescribe antibiotics yet as no infection had presented itself and the cultures from the blood and urine tests came back negative.  It was also felt that my body could still fight what might be going on given the current blood cell count and that my general demeanor was reasonably healthy looking.

Basically I was discharged with only Tylenol, white blood cell count of 1.6 and a healthy demeanor.  The condition on the discharge was that we may need to repeat the protocol if an infection did present itself.

Lo and behold guess what....

To be continued.....