11/8/19: Chemo Cycle #6 of 12 + Medical Oncologist Appointment + (11 Weeks Post-DMX) Physical Therapy Appointment #7

With today's treatment, I'm halfway finished with chemo!

My 8:15 appointment was the earliest it's ever been. Accounting for traffic, we left the house at 7:15, before the kids usually wake up for school. But today we made sure they were up before we left the house, and a friend in town drove them to school. Ken took the day off and drove today.

I got my port accessed (I could feel a small pinch, so I guess I didn't use enough numbing cream today), had some blood drawn, had my vitals taken, then went in for an appointment with my medical oncologist.

I mentioned that I've noticed my blood pressure has gone up. My pre-chemo blood pressure was always something in the 110s over something in the 60s. Now it ranges anywhere from the 110s-130s over 60s-80s. I guess it's still in the normal range, so not considered concerning, but it's still relatively high for me. My oncologist said the steroid can cause high blood pressure, and also just the stress of having cancer and being in active treatment can be a factor. Apparently both Taxol and Herceptin can cause high blood pressure, too.

I asked her for her thoughts on whether or not I can drive myself to future appointments, and she said it's really up to me, if I feel up to it. She did confirm that my chemo regimen is not expected to change.

The most important part of these appointments, I think, is for me to report my side effects, so she can make sure I am tolerating the treatment. If any side effects are too severe, she could adjust my medication doses, or prescribe additional medications to manage side effects. Anyway, all my side effects are so relatively mild that it sort of felt like I was looking for things to report! I guess I'd call that a good thing. My oncologist was pleased with how well things have been going.

She said to continue with the loratadine, since does seem to help with the cough.

She did a physical exam, and looked at my surgery incisions. She said what's left of the tiny stitch didn't look infected, so instead of triple antibiotic ointment, I could use Aquafor. But I shouldn't use a bandaid to cover it up, because she could see my skin was getting irritated. (Later at home, I discovered that a small piece of Glad Press 'n Seal works as a great bandaid alternative for just keeping the ointment in place and off my clothes.)

I mentioned that the area around the port was achy today, and I suspect I didn't put enough numbing cream on it. She said to just go ahead and be generous with how much cream to use, and instead turned her focus to the port incision. She said it doesn't seem to be healing well. I was glad she noticed, actually, because I've been disappointed in the way it looks; I'm anxious for it to heal, but it's not a smooth scar. There are still a couple small places where a scab hasn't fully formed, so it can't fall off. I'm not sure what's going on there. She said it doesn't look infected, so really there's not much to do but wait and see. Ken says they will cut me open in the same place anyway when my port gets removed, so I can just hope that the surgeon who does the removal does a better job with closing the incision! I mean, I guess that's true, but I'll still have my port for almost a year, so it doesn't make me feel much better about right now.

Finally, I'll mention that she looked at my nails, and reminded me to keep them cut short. I don't remember being told to do this before, so I looked it up when I got home. I found a helpful page from Memorial Sloan Kettering Cancer Center about how Taxol might affect nails, and what I can do to try to prevent nail changes.

I got settled in my infusion bay around 9:45, and started my pre-meds at 10:00.

My regular infusion nurse was back, and she gave me some of her thoughts on hair thinning. She said I definitely shouldn't shave it all off, because she still thinks I won't lose it all. She said she thinks my hair still looks good, that the thinning really isn't noticeable to other people. She said I could cut my hair shorter if I want it to look fuller, but I should only do it if I want to. I really appreciate how she and last week's nurse presented some options, but then reminded me that it's always up to me, that I should do what feels best for me.

When I asked my infusion nurse about whether or not I can drive myself in the future, she was quick to say that she definitely thinks I can. The concern is mostly about the Benadryl pre-med making me drowsy, but by the time I leave, I should have a good feel for whether or not I'm alert enough to drive. She suggested I do a trial run and drive home on a day when Ken is with me, so he can both observe me and be a back-up if I don't think I can do it.

My physical therapist came in around 10:30, and I started the Herceptin soon after.

The physical therapist worked on my cording for just a little while. She said it's so small now, maybe it'll be gone by next week. I told her about the muscle soreness I was feeling along my ribs, but around back. She was able to identify the muscle, and she gave me a new stretch to help that particular area. She also gave me a recommendation to follow a physical therapist on Instagram who is certified for oncology and lymphedema. She posts a lot of suggestions for stretches, including helpful videos.

I started Taxol around 11:15.

An hour later, a different nurse de-accessed my port, then looked curiously at my port incision, saying it looked red. She had my assigned infusion nurse look at it. My infusion nurse said it didn't look infected, said it's clearly still healing, and maybe there was a stitch or two not dissolving. She suggested I use some triple antibiotic ointment on it, and see if it helps. Ken mentioned that I had said I accidentally got some of the numbing cream into the incision today. She said it's okay, I should try to avoid doing that, but a bit of accidental exposure shouldn't be problematic.

My infusion nurse also brought me my blood work. 3 numbers were just slightly out of range: Baso (Basophil) was a little high, Im Gran (Immature Granulyte) was a little high, and AbsLymp (Absolute lymphocyte) was very slightly low. They're all related to white blood cell count, so they have to do with possible infection, or maybe even allergies. My medical oncologist had particularly asked me if I might have any kind of infection (I don't), and I wonder if these numbers helped prompt that question. Still, she said my overall numbers were good, so mostly I'll take these counts as a reminder to keep up with my handwashing and water drinking and other preventative measures.

We left just after 12:30, which means total visit time was about 4 1/2 hours. Incidentally, we did not get a free lunch today! Guess we finally stumbled on a time frame that didn't warrant it. Haha. Ken and I had a nice lunch out, and then we went to a nearby Costco. Surprisingly, we ran into a friend from town, spent some time catching up with her, and she said she wouldn't have known I had lost a lot of hair if I didn't tell her. That was nice to hear. She's a pretty straight shooter, so I think she meant it.