11/27/20: Lupron

I went in for my monthly Lupron shot today. There's nothing to report, I just chatted a bit with the nurse, who I hadn't seen in a few months. 

Incidentally, I think the Mederma Advanced Scar Gel is giving me a rash. The port incision feels itchy, and the surrounding area looks red. I've been using both the scar gel and the Mederma PM Intensive Overnight Scar Cream, applying the gel in the morning and the cream at night. They have different active ingredients. I'm going to stop using the gel and just use the cream at night. 

11/25/20: I Have a Lot of Joint Stiffness, and Other Side Effects

Joint stiffness is a common side effect of exemestane. The longer I don't move a joint, the worse the stiffness. Every morning when I wake up, this is as far as I can go in making a fist:

It's a little painful pushing through the stiffness. I have to slowly, gradually open and close my fingers until I can make a fully closed fist. 

If I don't use my hands for a while, or stay seated or standing in the same position for a while, the joints stiffen. Just the amount of time it takes to cook dinner makes sitting down afterwards feel like a huge relief on my legs. It's all manageable, but it's a nuisance, and makes me feel decrepit.

The tips of my thumb, index, and middle fingers on both hands are still very slightly numb and tingly all the time. It's just another nuisance now. It doesn't affect my ability to do any daily activities, but I do think I'm a lot clumsier than I used to be, like I always have butterfingers. 

My hands are still puffy, and my feet feel bigger, too. At least, my shoes and socks feel tighter. I don't know if it's fluid retention or actual weight gain, but if it persists, once this pandemic is over, I'm going to see about re-sizing my rings, which I haven't been able to wear since January. 

11/24/20: Echocardiogram

Today's echocardiogram was ordered by my cardio-oncologist. I think the idea is to make sure my heart function has returned to normal after finishing Herceptin. 

Instead of going to my usual hospital, this echocardiogram was at the cardio-oncologist's office, at a different suburban satellite location. I don't know if it was the doctor's orders or the technician I had, but the echocardiogram took longer than usual, like 20-25 minutes instead of 10-15 minutes. It seemed like the technician was taking more measurements than at previous appointments. 

Anyway, it was uneventful. I have the follow-up appointment to discuss the results with the cardio-oncologist next week. 

11/22/20: (7 Weeks After Port Removal) Incision Closed

Oh, that was much quicker than I anticipated! I thought it would take months for my incision to fully close, but it only took a couple weeks. I guess it made a big difference that the opening after port removal was much smaller than the opening after port placement. 

Here's what it looks like now:

It's prominent enough that I'm thinking of trying some scar-reducing cream on it. During chemo, my port nurse recommended Mederma. There's a whole line of products, I'm thinking of trying both the daily scar gel and the overnight scar cream.

11/12/20: I have Lyme Disease!!!!!

OMFG!!!!!

Can I not catch a medical break?!?

I know this is supposed to be a cancer blog, but I figured I'd make this post anyway, since I already mentioned the tick bite. 

So here's what happened, with pictures. 

The tick bite was on my waist. According to this very informative web site that dispels myths about Lyme Disease, "Ticks don’t jump, fly, or drop from trees. They crawl up." The tick probably climbed up the outside of my pant leg until it found some flesh to bite. Ugh. Gross! This is why you're supposed to tuck your shirt into your pants, if you want to prevent tick bites. 

This is what the bite looked like after the tick was removed:

The area just around the bite stayed a bit red, and the bite itself scabbed over. After a couple days it settled down to look like this, and stayed that way for about 2 weeks:

I figured, once the scab falls off, I'll be out of the woods. But no! After 17 days, I saw this:

An early symptom of Lyme Disease is a rash that appears between 3 and 30 days at the site of the tick bite. The CDC says the rash "may feel warm to the touch but is rarely itchy or painful"; mine is definitely warm to the touch and also definitely itchy. The rash gradually expands, and sure enough, 2 days later (today), it looked bigger:

But where's the bullseye?! The same myth-busting web site linked above says that less than 50% of cases involve a bullseye-shaped rash. In fact, according to the CDC, 20-30% of cases don't even have a rash at all. I guess I should be thankful that I did develop a rash; if my Lyme Disease symptoms started with a fever, I would have been worried about COVID-19 first, which would have delayed my Lyme Disease diagnosis for sure. If it started with fatigue and joint aches, I'd have chalked it up to my daily dose of exemestane, and who knows how long it would have taken to diagnose Lyme Disease!

Anyway. So today, 19 days after my tick bite, I called the doctor. My regular PCP wasn't available, so I saw another doctor in the same practice. I liked him; he was very calm and patiently answered all my questions. I told him the whole story, then he took one look at the rash and said, "I think we should treat you for Lyme Disease." He said it's possible I could have some other tick-borne disease, but the treatment would be the same, the antibiotic doxycycline.  

I said maybe it's not Lyme Disease, because as far as I could tell, the tick was probably attached for less than 36 hours, and some web sites say that Lyme Disease is "unlikely" unless the tick is attached for at least 36 hours. He said there's always a chance of transmission, it's just more likely the longer the tick is attached. Back at home, I found this web site that confirmed, "The risk may be low the first day, but it’s not zero... The longer a tick stays on you, the more likely it will transmit disease."

I asked if I should get tested for Lyme Disease, and he said it's not necessary because the rash is clearly related to a tick bite, and he would prescribe the same antiobitic no matter what the specific diagnosis is. He said testing is usually used when a patient has symptoms but no known tick bite, to figure out what's wrong.

He gave me a 10-day antibiotic prescription. The rash should go away, and no follow-up is needed. I should call again only if the rash doesn't go away, or if any symptoms persist after 10 days.

I've heard of people having chronic Lyme Disease symptoms, so I asked if Lyme Disease is curable? His answer was in line with what I later confirmed on the CDC FAQ: "Although most cases of Lyme disease can be cured with a 2- to 4-week course of oral antibiotics, patients can sometimes have symptoms of pain, fatigue, or difficulty thinking that last for more than 6 months after they finish treatment." I guess I will just cross my fingers that I fall under "most cases". 

11/7/20: (5 Weeks After Port Removal) The Steri-Strips Came Off

Following my nurse's recommendation, this past week I actively washed the port removal area, instead of just letting soapy water run over it in the shower. The steri-strips finally came off today. 

I don't know why this area is so slow to heal! As you can see in the photo, the top half of the incision is fully closed and healed, but the bottom half is not! I wouldn't call the bottom half "open", but the edges definitely were not pulled close enough together by the steri-strips. 

I guess this scar will need to heal in the same way the port placement scar healed; skin will need to grow in to fill that gap. At least the gap is not as big as it was before. But it will presumably take a loooooooong time to heal. Like, months instead of weeks. Again.

I'm pretty bummed. I was hoping this would be a smoother recovery, so that "port removal" could be a thing I could put behind me, instead of something that will drag on and on. So weird that my two massive mastectomy scars healed just fine - not to mention my C-section incision, twice! - and this small little incision has given me so much trouble. 

I feel validated in my decision to ask for a new doctor for the port removal. If I hadn't had a different doctor from my port placement surgery, I would totally blame this lack of incision closure on that doctor. I mean, maybe it's still the doctor's fault; maybe both doctors aren't very good at closing incisions. Or maybe it's just me, I'm just not healing well there, who knows why.