Thinking about Surgery

I have my surgery scheduled for late February! (Hopefully it won't get moved with too many skipped Taxols.) 

Trying to figure out what I want from surgery has been an exercise in managing expectations... My dream was to have immediate reconstruction, nipple sparing, DIEP flap. 

The surgeon I saw in Boston for a second opinion thought I'd be a candidate for nipple sparing but maybe she was just looking at my anatomy and not my case, because my surgeon here said that multifocal, aggressive cancer disqualifies you from NSM.

Immediate reconstruction was not recommended either, because they recommend waiting for the pathology report after surgery to determine if you need radiation or more chemo before final reconstruction.

Then the plastic surgeon I saw here said I'm probably too thin for DIEP (I guess we all feel like we have more belly fat than we actually do!)

So my current plan is to run with the expanders and then consult another plastic surgeon for a  second opinion about flap reconstruction instead of implants. I don't need to figure that out right away.

I'm also researching prepectoral implants, which are less disruptive. A bonus would be having expanders on top of pecs, which would be better for flap reconstruction. 

One of my big considerations is how I will take care of a toddler while recovering from surgery. In a way, it's a relief to hear I'm not a candidate for an immediate DIEP because that would be like 2 months before I could lift a kid. At least this way even if I can do DIEP he'll be a little older and maybe not sleeping in a crib, able to go down stairs, etc.

Taxol Weeks 2 and 3

Taxol week 2 rolled around and... I had NO white blood cells so I couldn't get chemo. I thought this was supposed to be easier on my immune system than AC! I felt pretty ok so I was surprised.

Week 3 arrived, I was deep in the throes of ANOTHER toddler cold. My bloodwork still wasn't good enough the day before. They had me do bloodwork again the morning of chemo to see how much it had improved but it wasn't good enough. At least this time they said we'd skip it entirely instead of adding more on the end. That's the part I'm worried about - I don't want this to drag on forever.

On the upside, my first week after Taxol was almost entirely free of side effects - I was maybe a little tired but no nausea. I don't think I realized how sick AC made me feel until I had this to compare it to. Hopefully I can get my bloodwork back on track for next week.

Starting Taxol

The next part of my treatment plan is weekly Taxol with Herceptin and Perjeta (pertuzamab -sp?) every third week.

The first infusion was a LONG day. I had to take 5(!) steroids the night before chemo - luckily I still slept but it totally freaked me out. The infusion took about 6 hours because the new drugs are administered slowly in case of a reaction. 

I froze my hands and feet during Taxol because I read a study about effectiveness in preventing neuropathy. I need to buy a cooler big enough for my gloves and socks! (I got 2 of each because they don't stay cool the whole time). I started icing 15 minutes before the Taxol drip started and continued until 15 minutes after the bag finished, switching gloves/socks halfway through.

I also painted my nails dark which might be an old wives tale but whatever, it looks nice.

Last 2 AC Chemo

Though each AC chemo hit me a bit harder in terms of side effects (mostly nausea), I found it totally doable with the help of my anti nausea pills. The last round, I took one around 5pm three or four nights in a row.

The hardest thing was the cold I caught from my toddler! Not being able to breathe through my nose while already having a dry mouth is no fun. The cold lingered forever (3 weeks at least). Ugh! 

I also got a fever a week after the 3rd round but it was so much better than the 1st fever because it happened in the morning when my oncologist was in the office. They ran all my tests there, determined it was just a virus (yes, the toddler cold) and I avoided the hospital.