First, Second, and Third Oncology appt's

 First Appointment

Once I leave Dr Willards office August 6th which is 4 weeks post surgery, I get my first appointment August 20th with Dr Phillips for a meet and greet at the Welland Hospital. Its now 6 weeks post surgery and I'm told that they need to start treatments by 8 weeks. Unfortunately I'm a complicated case with having Rheumatoid Arthritis with a history of having chronic neutropenia, and lets not forget also a history of having heart failure which is a scary word saying, you have a weak heart and we don't know why.  What is neutropenia? Well that's an issue with my RA affecting the production of white cells in my bone marrow. When you have RA your immune system decides to attack your body in my case 47 of my joints were affected amongst other things like my bone marrow, eye sight and most likely my heart. Your white blood count "WBC" is your little white army that fights infection, and if its too low that's not really a good thing, because should I contract say a cold I would be at a higher risk of getting pneumonia or possibly other serious infections like septicemia. When I go for my first appointment I see Dr Phillips my oncologist assigned to my case. I see his nurse first so she can over my medical history which takes a little while, then she confers with him before I see him. He proceeds to come in to let me know what the final surgical pathology report indicated. He draws me a diagram of where exactly they find the cancer in the breast, how many lymph nodes are tested and have disease than tells me that my cancer is Stage 2 Metastatic Breast Cancer, because it has spread beyond the breast. Grade and Stages are two different things a Grade is based on a scale of 1-3 and I'm at a 3 which means its growing fast, faster than my liking that's for sure. It's also T2 meaning the tumor is between 2-5 cm in my breast, and its also N1 which means that it's in 1-3 nodes, lucky me it's in only one, all be it very large, lymph node and it has already penetrated the membrane of the lymph node but not gone through, again I'm feeling lucky, maybe I should buy a lottery ticket. Pathologies report of the cancer cells are ER+HER2+ the HER2+ is what they generally find in younger woman and only 10-20% of woman over 60 have that type of cancer cell which is invasive and aggressive. I guess my body hasn't got the memo that I'm considered old, the nurse that takes my vitals the day before chemo says I definitely don't look 62 who doesn't like a compliment, I do until she says I look more like 55. Really I say, I look 55 like 7 years younger only I was kind of hoping I looked better after all my amazing mother in law who is 91 looks 75. Definitely going to take care of that when I get over all these treatments, facials to get rid of those sincerity lines, new hair style once the hair grows back in, get this old body back to the gym.

Were on a time crunch and the oncologist has a little dilemma, which treatment plan to use to treat this aggressive cancer growing in my body, if not for my weak heart the plan he would ideally like to use would be AC-PACL(DD)+TRAS "Cyclophosphamide, Doxorubicin, Paclitaxel, Trastuzumab" every 2 weeks. He proceeds to tell me that if that's not good he does have a plan "B" "C" and "D" if need be. He decides to confer with a cardio oncologist at Juravinski cancer center in Hamilton and he's able to pull strings to get me in to see Dr Leong Monday August 25th, he also schedules me for a PET Scan Friday August 29th and in between that we have chemo class Thursday August 28th. I'm amazed at how fast things are moving along now which my sister Lisa warned me would happen once I saw the oncologist. I don't have time to worry but I'm a bit overwhelmed with all the appointments. When I leave they make me a second appointment to see Dr Phillips, Tuesday September 2nd to get all the results of the testing that has been done, and which happens to be the day before my first chemo treatment.

Second Appointment

When I see my oncologist September 2nd he says after having the Echocardiogram Transthoracic (TTE) my heart is not ideal for the first treatment plan, because the Doxorubicin which is part of the first treatment plan is known to permanently damage the heart by 1-2%,  not bad odds if you have a good heart, unfortunately after having the (TTE) test my weaker hearts percentage  jumps to 15-20% and the risk is too high to take for more heart damage. Dr Phillips says we don't want to treat you for cancer only to die of heart failure. Now the Trasztuzumab which is the same drug as Herceptin is used in both plan "A" and "B" it too affects the heart but its only temporary, and the heart will recover. The Traz has been proven to be very effective in treating HER2+ breast cancer, it's an immunotherapy drug and when combined with other chemo drugs works well. Yay for science!!!! So clearly the decision to use plan "B" was based on the results of the (TTE) and Dr Leong's report. I have to be honest here having chemo every 3 weeks as opposed to every 2 didn't hurt my feelings any, not that I had any idea on how chemo would affect me. Lastly I was informed that there was only a 1-2% difference in survival so not a huge difference.

Plan "B"

CRBPDOCETRAS:

Carboplatin, Docetaxel, Trasztuzumab, 

5 hrs first treatment due to getting a loading dose of the Trasztuzumab along with the other two drugs.

4 hrs the next 5 treatments which if all goes well I will be done with the worse around December 17th, I may not feel the best for Christmas but we can at least celebrate the worse being over I hope!!!

Third Appointment,

Every oncology appointment precedes with bloodwork the day before, this way they are sure your WBC is good for treatment the next day which will be Wednesday September 24th. We go over the results of the blood work today which are concerning, because after having a "Lapelga" injection 2 days after my last chemo treatment, which was supposed to stimulate my bone marrow to make more white blood cells, my WBC are only at 1.3. Not good, those stubborn little shits are not suppose to roll over and die, they are suppose to stand at attention so that they can fight for me another day. Ugh I don't really want any delays, like Samantha said really hoping here its a one and done deal!!!! So tomorrow September 24th I need to be at the hospital for 6:45 to prep in order to get my PICC line in at 7:45, then do a repeat bloodwork to check my neutrophils, this way a decision can be made on if they will be able to proceed with treatment tomorrow. Shawn immediately Googled how to get my neutrophils up when we got home, because like me I don't really want any delayed treatments, he tells me that protein helps. So I stopped at Lemayzz meats tonight to get a nice big fat protein loaded steak!

Another option is injecting me with a different drug for 5 days starting 2 days after chemo to see if they can get my bone marrow working a little better, for my next treatment. Crossing my fingers here!!! Funny how your life can change in one quick moment, I for one never thought for a second that this could happen to me. Unfortunately it did and now I'm angry and I'm ready to battle. Battle for my life because I have lots to live for, I have two beautiful grandsons that I want to see grow up and a family that I love more than life itself. 

Don't you love Fall and the beautiful colorful mums that are out right now, so in closing I've included photos of the things that have made me very happy this week, not to mention having the best friends and family a girl could ask for!!!!