Chemo Cakewalk

March 28, 2010

Good morning all!

Well.  LOADS to report.  Can’t promise to get through it ALL this morning, but I’ll try.  (Upon completion of typing and re-reading this post, I must recommend popping a big tub of popcorn and grabbing a large beverage before reading.  It’s l-o-n-g.)



That appointment at MD Anderson finally came through and, even though I really liked everything and everyone at Baylor, it seemed a bit retarded to turn down a second opinion.  As I expected, the second opinion in regard to diagnosis and treatment recommendations was the same as the first.  This was simultaneously encouraging and disappointing considering the depth of resources at MDA and their reputation to be on top of all the latest and greatest.

After a lot of mangling of my last name and rather dispassionate, “Sit over there,” “Come with me,” “If you agree with all this, sign here,” commands, I finally got through the registration process.

Easily the most disappointing (and yet oddly, reassuring that I had made the right choice) part of our visit was the physician assistant’s diatribe about all the patients that opt out of their protocol for treatment in favor of snake oils (my words, not hers exactly, but definitely implied) in the form of herbals “soaked in cat urine” (yes, her words. I couldn’t have made that up if I tried.) 

For those of you that know my mother, I’ll leave to your imagination how well this lead balloon flew.  As a result, I did not share my plans to make a voodoo doll of myself when my hair starts falling out.  (Of course, we won’t be sticking pins in it!  I was thinking of something more along the lines of little finger massages, reading bedtime stories to it, lots of kisses, a nest of $100 bills to sleep on (accepting donations now), and so on.)

Next up was the actual doctor who will remain nameless so as not to sully any reputations.  I actually liked her at first.  Very knowledgeable, encouraging, personable.  Well, all of this fell apart when she was unable to discuss “quality of life” issues (including decrease in libido and vaginal dryness – two known side effects of chemo) in mixed and multi-generational company.  She literally – I kid you not – dissolved into the uncontrollable giggling you would expect from a 13-year-old girl, covering her face and blushing.  She never recovered sufficiently to answer the question and the consult ended less than 4 minutes later. The fact that this woman heads the ‘breast cancer in young woman’ group at MDA is outrageous.

Fortunately, it was not a complete waste of time.  I am now officially a patient at MD Anderson (in addition to Baylor) which means I can make use of any of their services.  I asked for a referral to Dr. Richard Lee, the oncologist at MDA known for working with their Integrative Medicine department.  I am hoping he will be able to give me a definitive thumbs up and down review of the herbal supplements I would like to resume taking.

FRIDAY – Chemo Round 1 of 6

Went to the Baylor Clinic to get my first round of chemo.  I swear, the staff there really couldn’t be greater.  Sometimes it’s the simple things.  For example, when you are a new patient filling out the paperwork, rather than calling you back to the desk to retrieve your driver’s license and insurance card, they bring it out to you.   And while they could figure out who you are by the picture on your license (well, maybe they could), I’ve watched time and time again the intake staff walk directly to that person without referring to the picture to remember – they take the time to remember you when you introduce yourself.  How could something so seemingly simple have become such a widespread, “I don’t get paid to remember who is who!” attitude?  And why do employers put up with it?

Anyway, got to the clinic, got all situated in my recliner, met my nurse, Kendall (who is not only terrific but, barring unforeseen circumstances and for the sake of continuity of case history knowledge and care, the same one I will have for all of my chemo rounds) and got started.

First, access the port.  With the lidocaine cream they prescribed the day before already on for 45 minutes, I barely felt a pinch.  Then, blood draws (4 tubes, I think) for the drug trial I agreed to participate in.  Blood draws – at Baylor anyway – can now be drawn via my port which saves me from getting stuck in the arm.  Benadryl and Tylenol by mouth to slow down any adverse or allergic reactions.  Kytril and Decadron via IV to help prevent nausea during treatment.

Then the real stuff.  First, Herceptin set to drip over 1.5 hours.  Future drip time for everything except the Avastin is 1 hour – they just like to take it slow the first time.  They were a bit concerned about the fact that I flushed a little but, after asking if I flush easily and showing me my face in a mirror, I told them they should see me after two glasses of wine!  That this was nothing in comparison.

We then moved on to Carboplatin (1 hour drip) followed by Taxotere (1.5 hour drip) and finally, Avastin (1.5 hour drip) or, because it is a double-blind study, saline.  During the Avastin-or-saline drip I started to feel warm so we took my temperature.  It was only 99.5 which Kendall said was nothing to worry about and just a sign of my body trying to do battle with all the drano being introduced. In the final flushing, I got some Heparin, a blood thinner, for good measure.

From what I understand, this will be the usual drill for five more visits every 3 weeks – next one, April 16th (my mother’s birthday!)  With quite firm instructions to NOT wait to “see if I feel nauseas” before taking the oral nausea medication and to call IMMEDIATELY, day or night, if my temp went over 100.5, I was sent home.

On the advice of former chemo patients my mother knows, I walked the last mile home.  I’m not sure if this was to churn up all the chemo and get it into the furthest reaches of my body or just to keep me from crawling into bed and curling up in a self-pitying heap, but whichever the case, I guess it worked.  I took a shower, heard that Gabe wanted to see me after driver’s ed class, talked with my sister who is in town this weekend, got a bizarre phone call from my mother (explained next via the email I inserted) and then Buck and I walked to pick up Gabe thus adding about another mile to the day.



Dear Ms Reilly

We almost finished the analysis for your daughter Christine Borja.

We did not find CTC (circulating tumor cells) in the sample and can’t therefore provide treatment suggestions.

Generally, our detection rate for CTCs is ca 80% in advanced stage CA.  In the case of your daughter the overall count of cells in the tumor cell fraction was unusual low, thus the negative CTC result might be sample related. So, I think it would be worth a retry in this case. If you agree re-testing, we would cancel the first analysis and would do the re-test w/o charge.

Dr Prix

Or, maybe I just don’t have cancer?


Well, if my response to Round One sets the marker from which I will slowly deteriorate, it’s a pretty high mark.  It’s hard for me to figure out if this is a good thing or not though.  In my “Tina’s World”** interpretation of cancer and it’s treatment, the chemo has been sent in to kill cancer cells.  Anything that opts to stand its way, most notably white and red blood cells just trying their damndest to do their job, will be killed as well.  So, if I’m feeling, overall, pretty damn normal today, that means the chemo is going to have to work harder to get through the blind loyalty of my white and red blood cells to finally get to those lazy fuckin’ freeloading cancer cells.  (This assumes Germany is wrong and there ARE in fact cancer cells still in there.  If not, “Tina’s World” isn’t sure why we are having chemo at all.)

So, yes.  Other than being ready for a nap – but then again, when am I not? – and feeling a bit bloated – but not nauseous – I feel fine.  Even the feverishness was gone by 8 PM last night.

Of course, at ANY moment I could start to feel quite crappy and helpless so don’t get any crazy ideas that I don’t need help.  In other words, don’t worry that I may have lost my tiara!

** some of you are aware of my sometimes unhelpful – and sometimes not unhelpful – oversimplification of terminology, processes and otherwise needless convolutions of philosophy.

I’ll wrap it up here. 

Thank you all for everything – now, then and then again.



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