10/11/19: Chemo Cycle #2 of 12

Previously, in preparation for the port access, I pretty much slathered the numbing cream on my port rather generously. Today, I thought I'd try to use it a bit more sparingly. It still worked! I didn't feel the needle going in at all. Incidentally, I did feel the needle coming out (which I don't remember feeling last week), but still with a kind of dulled feeling. I wouldn't call it painful, just a very brief pricking feeling.

The port nurse "flushed" the port, and drew 2 vials of blood. She needed to draw a third, but the blood didn't fill the vial. She had me take some deep breaths, which can help reposition the port catheter inside the vein! Weird. She still couldn't draw any blood, and she said she could tell that the catheter was "up against the wall" of the vein. So she flushed the port again, had me take some more deep breaths, and also had me pull my shoulders back, and then she was able to get the third vial of blood.

Interestingly, the port nurse asked me if I had drunk "enough" water this morning. I did purposely drink 16 oz. before leaving the house, but maybe that wasn't enough. She said staying hydrated helps, and I should try to make sure I drink "enough" the evening before, too. I'm making sure to get at least 64 oz. a day of water, not including other liquids like soup or non-water beverages. I'll start paying particular attention to water intake the day before and the day of chemo.

The port nurse also commented that my port incision was healing nicely. I said it's kind of funny, my two major incisions from double mastectomy surgery were so clean and flat from day one, but the smaller port incision looks worse. She said the port surgeons just aren't as good at prioritizing the cosmetic outcome. Except this one surgeon, she named him (not the surgeon I had), and she said she could always tell when he was the surgeon because his work is so well done! Too bad I didn't get him. Ha. Anyway, she said my port incision still might look better when healed, I'll just have to wait and see. But if it bothers me, after it's fully healed, she recommended Mederma to lessen the scar's appearance.

With my port accessed, we headed upstairs to the infusion room. Ken came with me again to today's appointment. The overall time was less than last week's by over an hour; Ken didn't have time to finish his grading!

I got my vitals, settled into my bay, and the nurse came in around 12:00 to start my infusions. She asked me about any side effects, and seemed to find the cough a little concerning, enough to call my medical oncologist so she's aware. She said we'd "keep an eye on it". Herceptin can weaken the heart, so she asked me if I had any other symptoms like shortness of breath or trouble going up stairs; I haven't. She said to be especially vigilant about signs of infection, to stay away from sick people, and to call at the first sign of something not feeling right. A temperature of 100.4 is considered a fever, but she said to call even if it just gets over 100. The nurse confirmed I should get a flu shot, but she said we'd do it next week. For now they want to watch the cough, and don't want to introduce too many variables.

Since I responded well to treatment last week, we were able to ease up on some of the pre-meds. No Tylenol. I took the steroid (name brand Decadron) by mouth instead of via IV through the port; that shaved some time off our visit. I still got Benadryl by port but it was half the dose of last week. And the Pepcid by port was the same as last week. The Benadryl still made me feel kind of loopy, but not nearly as bad as last time!

My primary nurse was the same nurse as last week, but other nurses sometimes stepped in as needed. The pre-meds took about 45 minutes. Each time an IV drug stops flowing, the IV machine beeps, and a nurse comes to switch out the IV pouches if the drug is finished. Sometimes the machine beeps, but there is still medicine left in the pouch, so then the nurse jiggles the pouch or fusses with the IV tubing, to allow the drug to finish for real.

After the pre-meds finished, we had to wait for the Taxol and Herceptin to arrive from the pharmacy. I started the Herceptin at 1:00, and it was delivered over 30 minutes, instead of the 90 minutes that was needed for the initial treatment. That cut down another hour from our total time.

At 1:30 I started the Taxol, which takes an hour. Every time a nurse administers the Taxol or Herceptin, they ask for a "check", and another nurse comes over. I give my name and birth date, they match it with my wrist band, and then one nurse reads off my medical record number while the other nurse confirms it. Then one nurse reads the same information off the drug pouch and the other double-checks it against the paperwork. They also read off the drug's expiration date, and I think both drugs expire in like 12 hours or something. I thought that was interesting.

Once the Taxol was finished, the nurse de-accessed my port, gave me my blood lab results that I requested, and we left at 2:45. All told, it was less than 3 hours to administer the medicines, but just over 3 hours total including the port access and blood draw.

I find the blood lab results fascinating. There's a lot more data than is explained in that link, so I don't understand it all. But a lot of numbers went down, some went up, and a couple were just on the cusp of the normal range. The only number that was squarely outside normal range, on the high side, was my "Im Gran" number. I think that's a count of "immature granulocytes", which I am learning are immature white blood cells, so they are involved in fighting off infections. I don't feel unwell, but maybe my body is already fighting off an infection, or is getting ready for a fight? I guess it just reinforces how I need to be vigilant about washing my hands and avoiding sick people.

Speaking of feeling well, like last week, I don't really feel any side effects tonight, except minor things like a dry mouth and that little cough. It's possible the steroid pre-med is giving me an energy boost, but I'm usually a night owl anyway, so it's hard to tell. It's nice that at least so far, we have been able to keep up our Friday Family Fun Night tradition of playing a board game or watching a movie.