This morning I had a follow up visit with my oncologist. But at a University teaching hospital you always see someone else first. It could be a medical student, a fellow, a nurse or physician's assistant. I love it when I get to see Kelly, his physician's assistant. She is as knowledgeable as he is about most day to day treatment questions and she has a wonderful sunny personality. She is the go to person I call with questions and problems. But today we got a medical student. Some days I have tormented them and not let them examine me. It depends on if I see their hands shaking. This one seemed pretty confident and thorough so I was patient and answered all his questions even if he didn't really understand that I was there because they called me, not because I really wanted to be there.
I'm pretty organized so I reviewed with him my monthly calendar that lists all the medications I have taken since my last chemo. Including things not prescribed by them like the antibiotic for the skin infection and every Advil. Then he reviewed side effects. I went over the two biggies; bone pain followed by muscle aches. He then tried to rule out the other side effects. He asked, "Any dry mouth? Any metallic taste in your mouth?" "Of course", I replied. And the list went on. Night sweats. The only one I don't seem to have yet, loss of appetite. Unfortunately. I'm the only person in the history of time to gain weight while on chemo. But for a while after each chemo the only food I wanted to eat was cake donuts. I'll have to ride hundreds of miles on the bike to work those off. And to avoid the bad taste in my mouth I have found that chocolate or Werthers Originals works best. Basic sugars. Interspersed throughout some days with fruit and whey protein shakes. Dinners at home are veggies and fish or meat. OK, I can't resist desserts. Darn those cake donuts and desserts.
Finally the oncologist comes in. He's growing on me. I decided today that I even like him. I think I will be all right with having him in my life for the next five years. He joked as he came into the room today, "I hear you've been having a rough time of it. I'm really not trying to kill you, you know." I think I answered, "you could have fooled me."
He had reviewed everything before I got there and it wasn't really a discussion. He is changing out one of the chemo drugs, Taxotere, for a different one, Adriamycin. So I will be on a combo called AC. the C will stay the same, it stands for Cytoxan.
Here is a description of the drugs that I found that makes the most sense from MyBreastCancerNetwork.com Not sure it is the best description but it is the first time I have read something about chemo that explains it simply and clearly:
The "A" part of this "chemo cocktail" both blocks DNA production in your cells, and also inhibits the enzymes responsible for repairing DNA. Cells can't live without DNA; thus when they're deprived of it, they die (in fact, some even kill themselves when their DNA is damaged). "A" can't distinguish between cancer cells and normal cells; but because cancer cells are dividing so rapidly, it has a greater negative effect on them than on your normal cells. The "C" part of this chemo combo stops cancer cells from replicating. So between them, you have some pretty powerful agents working to destroy those cancer cells.
This drug change eliminates the side effects of Taxotere. I won't get either the terrible allergic reactions during the delivery of the chemo and the 9 days I was pretty much flat on my back immediately after the chemo. The only potential side effect impacts the pumping of your heart muscle. It happens in less than 5% of the cases. I reminded him that perhaps as I had every other bad side effect this might happen to me. He seems highly confident that it won't. The heart problems typically happen with a high number of treatments (6). So the side effect is based on cumulative Adriamycin dosage. I will only be getting two doses. We'll see. I have to schedule an EKG before chemo to test my heart and make sure I am going into it healthy. I'll let you know how it goes. Soon I will be half done.
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