Sleepless in Bed

12 hours from now, I'll be sitting on that La-Z Boy-looking chair again, while trying to watch TV or maybe reading my book of the moment. 

I'm not going to lie ... I'm anxious about going for chemo cycle 2. The only difference is that this time, I know exactly what to expect. So I guess the anxious feeling isn't as intense as the first time. But this is why I'm in bed, but can't sleep.

I've requested for more prayers for tomorrow and I'm humbled by the response I got from friends --- close and otherwise. 

In not so many words, let me just say that today was the most challenging day for N and I since this journey began. It was overwhelming, to say the least. I found myself focusing on this bible verse. We are so blessed to have neighbors whom we can talk to whenever we need guidance and reassurance. 3 houses down from ours live the most accommodating and warm couple in this small community. Pastor R and his wife, A have also invited us to be part of their D-group. We've only joined them once but N and I are in agreement that we want to keep going back. Anyway, all it took was one text message from N to Pastor R and at around 9pm we were seated in their living room and Pastor R was praying for us.

I continued to pray when we got home ... I needed time alone to talk to the Lord in the manner that I usually do. I can't have anyone else in the room when I do this. 

So anyway ... I should've hit the sack a lot earlier than this. If you're reading this, please say a quiet prayer for me as I face the frenemy again tomorrow. Thank you and God bless you! 

Less Than A Week To Go

There's no date set for my 2nd chemo cycle yet, because everything will depend on my blood test results. I'm getting those tests tomorrow and seeing my Onco with them on the next day. This is protocol for chemo. The doctor needs to make sure your body is ready for each upcoming infusion.

As the week draws near, I'm feeling a bit under the weather. I'm not sure if it's all part of the anxiety or because everyone around me has been sick. Before the first cycle last Oct 23, I remember telling my Onco that I felt like I was coming down with something and she immediately dismissed it as stress because I was nervous. She was right, I didn't get sick at all.

Here's a confession : I am a bit nervous again even if I already know what to expect. I think it's more psychological than anything. I know I should be dwelling more on the fact that I'm so lucky I can go home after each session. But I can't lie. I was so uncomfortable the first time and I felt sick (again, pyschological). I'm going to pray so hard that it won't be like that again. I take my hat off to those who go to their chemo sessions as if they were just going to the grocery, with no companion. I know I've been so strong all this time, but I don't think I can ever go to chemo just by myself. I need someone there to distract me and to talk to. 

PRAYER WARRIORS, I need you :) 

Challenging Day - lab tests for Sabine and Chemo Cycle 1

Yesterday was another huge day. It was the first of a series of chemotherapy sessions at The Medical City. But as if that wasn't enough, we had to be in Cardinal Santos in the morning, for another CBC test for Sabine PLUS a Dengue Test as recommended by her Pediatrician. All's well that ends well, Sabine was declared negative of dengue based on test results. It's a virus and she's recovering from it well with her anti-biotics. I wanted yesterday morning to be as relaxed and quiet as possible, because the chemo was making me feel a bit more nervous than I was in the past few days. All I could think of while I was praying yesterday was, Hay naku, Lord bilib na bilib ka talaga sa lakas ko! But thank you for sparing my little girl!

It was N who stayed with me yesterday, instead of Mama who originally wanted to be there. But Sabine got sick and still stayed home from school yesterday, so Mama thought it would be better for her to stay with the precious grandchild. It turned out to be the best for everyone. Mother's know best? :) 

Here we are at the Chemo Unit's big waiting area, waiting for a cubicle to become available. We were told that some of them were closed due to ongoing construction work on the floor above them. 

My bodyguard opening the door for me hehe!

My Oncologist, Dr. Marina Chua-Tan, prepping my vein for the infusion. She has the softest, kindest voice and explains everything with so much patience. It was N's first time to meet her yesterday, she was generous with the information she shared to him.

These photos are giving me goosebumps :/

For the looooooongest time I wasn't afraid of needles. They were never a source of stress for me, unlike some people I know. But since the surgeries, I've looked at needles from a less-comfortable point of view. Although my doc used the plastic type yesterday, it hurt just as much as the traditional one when it was inserted. To be fair to her though, she said this was the only pain I was going to feel all throughout and she was right. The pic on the left shows the needle guide. HORRORS.

The nurse came by another half hour later to infuse the chemo meds. 

Strawberry Flavor? I think not. This particular med is supposed to be so bad ass, it can cause a really disturbing burning sensation on your skin if the nurse doesn't administer it properly. It also turned my pee into pink! I had to flush it out with lots of water afterwards.

There were 2 other meds infused. I need a combination of 3 of them during the first 3 cycles. The next  2 hours were pretty uneventful, except for a really short moment when the flow felt mahapdi. The nurse was still there so he was able to make the necessary adjustments. Before I knew it, I had dozed off although very lightly. It was all psychological, but I didn't feel at ease about the fact that there was something so complicated attached to me. Besides, the machine was kinda noisy.

Emote! :)))

The 2 hours went by just like that. We were out of there by around 5pm. I wouldn't call it a bad time, because I'm thankful that nothing went wrong while the treatment happened. But honestly? I felt this really nagging kind of restlessness in the first few minutes after the infusion, when my Onco had already left the room. I couldn't explain it and I still can't. I can probably attribute it (still) to first-time jitters. It was emotionally overwhelming because this really made it sooooooo real. I was okay by the time it was over but I wanted to go home stat!

When I arrived, I had a hearty dinner of Sinigang na Sugpo and Rellenong Bangus then went to bed earlier than usual at around past 10pm. I woke up shortly before 9am this morning --- wow! Thank you, Lord for uninterrupted sleep! I felt blessed upon waking up.

It's already 1pm and I'm still feeling as normal as I do on a regular day. Friends have been asking me how I'm doing and they're all surprised and happy that I'm not feeling any side effects. I pray that this goes on until my next cycle. This is something we will constantly pray for everytime I need to go back.

God continues to bless me and I'm so grateful!

ONE DOWN, FIVE TO GO!!! 

When It Rains ...

We all know what comes after that. My first chemo cycle takes place tomorrow afternoon. I really should be relaxing right now, maybe even getting a massage to calm my nerves. But instead of focusing on being calm, I'm exactly the opposite. Sabine still has a fever, in fact, it shot up to 39 deg celsius just an hour ago. The Pediatrician said earlier, this is what concerns her. It's the high temperature that prevents her from ruling out Dengue just yet. It could still be a bug, but we can't entirely say, it's not Dengue. Sabine had a CBC earlier today and the result was okay but borderline. So the Pedia wants to do a repeat in the morning, plus the Dengue Test, while we monitor her fever for now.  All this is happening while I'm trying to psyche myself up for when I enter unknown territory tomorrow. As a Mom, I've always been the panicky type.  It's genetic, I think. No one can tell me not to panic when it's my kids we're talking about. It will be really difficult for me to get some sleep tonight and that's me being very, very honest about it, even if I know a lot of people will disagree and tell me I need to get enough sleep. 

It's a good thing I already sat down to make a list of things I need to bring to the Chemo Unit of The Medical City tomorrow : 

My meds (Onco asked me to buy 3 kinds), including the anti-nausea patch Dra. Marina recommended. This patch would've cost me P3,900+ in Mercury Drug. But purchased directly from a MedRep, I saved about P400.00. This is supposed to last 7 days. I hope it works!

A shawl or small blanket - I'm usually sleepy at the same time the chemo will take place. I hope I'm comfortable enough even with the IV attached to me, so I can nap a little and not dwell.

Snacks - yup, my companion and I are allowed to eat in the private cubicle, which also has a TV

Water - I'll need to drink lots so I can also pee lots and, therefore, flush out whatever it is that needs to be flushed out

I guess in that sense, I'm all set. Emotionally? I don't want to say. I'm not going to pretend that I'm not nervous because I still am. Maybe I'll even be more nervous once I'm there. I'm not beating myself up about it because everyone, including my Oncologist says, it's all part of the experience. 

Seriously though, I'm really stressing out more over Sabine's fever. I've been praying for it to go away. I can't deal with anyone else being sick at the moment. The spotlight belongs to me! 

Tomorrow's surely looking like one heck of a busy day. We start out early (I was really planning on waking up late, but that's out of the question now) with a trip back to Cardinal Santos Memorial Center for Sabine's CBC and Dengue Test. Then I can go back home and stay there for a while, gather my stuff (and maybe my guts) until it's time to head to the Chemo Unit. 

I tried Googling for photos of the Chemo Unit at The Medical City. Unfortunately, I found none. I'm told it's going to be really private and comfortable. The private part is something I would demand. One of my concerns was being exposed to other cancer patients, especially those who are not doing as well as I am. I don't want to be in the same room, my heart won't be able to take it. My doctors assured me that this would not be the case at all. Relief!

Philippians 4:6-7 
Don't worry about anything; instead, pray about everything. Tell God what you need, and thank him for all he has done. Then you will experience God’s peace, which exceeds anything we can understand. His peace will guard your hearts and minds as you live in Christ Jesus.

My Chemotherapy Treatment Plan

Different cancer patients get different treatments based on their actual condition. So far in all the talks I've had with my doctors, especially my Oncologist, I've learned that treatments are somewhat customized. The doctor will have to take a look at all your records, even your medical history, in coming up with the kind of treatment that's suitable for you.

The first time I ever sat down with my Oncologist, she already mapped out my Treatment Plan for me.

In my case, I need 6 cycles of chemotherapy and NO RADIATION. I stressed on the latter because it's a blessing that I don't need it! The 6 cycles will last for 18 weeks because the cycles need to be 3 weeks apart. I start on October 23rd so after looking at my calendar, I've already marked the week when my last treatment will take place and that will be on the last week of February 2013. I consider this to be another blessing. Why? Anissa celebrates her 17th birthday end of March, Mom will turn 63 on the first week of April, Sabine will be 7 years old on April 18th. I'll be well enough and back to my normal self by the time all these milestones are going to happen. I'm already excited just thinking about it! 

But wait ... going back. I asked my Oncologist to explain to me what exactly will happen in each cycle. Will each session be different? What medicines are going to be used? What are the common side effects? How long will each session take? How many family members are allowed to keep me company? Etcetera ... etcetera ... etcetera

First things first ... WHAT MEDICINES WILL BE USED? Again, just to clarify : this is for me. It may be different for the next person, even if that person also has breast cancer. 

The first 3 cycles : FEC - a combination of 3 medicines. F stands for Fluorouracil, E stands for Epirubicin and C stands for Cyclophosphamide.

The last 3 cycles : Taxotere 

# 2 WHAT ARE THE COMMON SIDE EFFECTS?

Hair Loss - yes, my Onco says it WILL happen to me. Some people have told me it's also possible that I won't lose my hair. But I'm prepared, my Onco was honest with me from the beginning. If for some reason she's wrong, I'll treat that as a wonderful bonus. 

Nausea - she prescribed an anti-nausea patch called Sancuso. It's quite expensive at around Php 3,000+ a piece but she highly-recommends it. To be totally honest, this is the part I'm dreading. It's the main reason I quit drinking many many years ago. My tolerance for alcohol is really low and I used to throw up a lot after coming home from parties and gatherings. I absolutely hated the feeling each time. I'm really hoping this expensive patch does its magic!

Fatigue - they say it's going to feel like you have the flu minus the fever, so it'll keep you in bed

Mouth sores - one of my Onco's ex-patients (5 1/2 yrs since diagnosed) told me she had these. Yikes.

Taste changes - many have told me to keep on eating even if walang gana or even if the food doesn't taste good. You can always ask your Oncologist how to cope with this. I know I will.

Bladder irritation and diarrhea - need I say more?

Some other side effects but are less common would be : skin changes (rash, itchiness), sun sensitivity, nail changes (dark or white lines on the nail beds). 

#3 HOW LONG WILL EACH SESSION TAKE? 

Mine will take 2 hours each time. I asked my surgeon if I would be exposed to other chemo patients. I'm afraid that seeing those who are really weak and sick-looking might affect my disposition and I don't want this to happen. I'm also a real softie when it comes to these things. She assured me that I'll have my privacy. Each patient does. There's an enclosed cubicle for each patient, with a La-z boy and an extra chair for a companion plus a TV. I can do whatever I want. Read a book, eat, sleep, listen to music. It's all going to be comfortable according to her. 

#4 HOW MANY FAMILY MEMBERS ARE ALLOWED TO ACCOMPANY ME?

One inside the cubicle. If there's more than one with you, the others will have to stay outside. I think there's a waiting area within the Chemo Unit of The Medical City. I don't plan on bringing an entire baranggay of family members with me. Please don't do this either. You might jeopardize the health of other patients getting their chemo treatments by exposing them to so many germs.

#5 WHEN IS MY HAIR GOING TO START FALLING OFF?

Usually 2 weeks after chemo starts. That means I'll be baldy by the time I turn 44 on November 17th. Wow, it's gonna be one memorable birthday!

These are the things I've asked about so far. Oh ... of course, I also asked about the costs earlier on. I know how much each session will cost me. The first 3 will cost the same, the last 3 will be a lot higher GULP. I'm not too comfortable about stating the figures here. If anyone wishes to know, feel free to email me at graceandanatomy@gmail.com and I'll get back to you.

Also, please remember that each time the doctor tells you that you need to go through something, take a specific kind of medicine or whatever it is ... it is your right to ask questions if you don't understand. I don't really care if any of my doctors think I'm makulit. Hello?? I'm not a doctor, I need to be educated. Plus of course, it's my body and I have to know every little thing that goes in it and what it's for. If your doctor doesn't have the patience to answer all of your questions --- whether he/she thinks they're valid or not --- please do yourself a favor and look for another one. You really don't need the added stress. Your doctor needs to be your friend and ally, not someone you feel uncomfortable talking to. 

There you have it, my treatment plan. My wellness plan, if you wanna call it that. I think I'm starting to lose some of that anxiety I've been feeling. I just really want to get things started and over with. I hope you all stick around to see me fly through this! 

P.S.

Such wrong timing but Sabine developed a fever earlier tonight. She also has a cough and a cold and says her throat is slightly "ouchy". Not now?!?!  So I texted my Onco and asked her what I should do. She said the following : 

Gargle with Bactidol 2x a day (you and your daughter)

Have your daughter's pediatrician determine if she needs to be on antibiotics

Stay in a separate room whenever you can

If she has to be with you, make her wear a mask (change every 4 hrs)

Disinfect all door knobs and common areas religiously

I asked her if she thinks I should leave the house and camp out at my Mom's. Her reply was "huwag naman!". Whew. 

It's Real and It's Here! (More thoughts on chemo)

At my Oncologist's clinic yesterday, I told Dra. Marina that I was feeling a bit under the weather, like I was coming down with something (the ridiculously cold air-conditioning at The Medical City made it worse!). She didn't bat an eyelash and said, "You're stressed out about starting chemo. It's normal but try your best to relax about it." I guess she's heard and seen it happen a thousand times. 

I've asked myself what I'm really afraid of and why. Before the surgeries, I don't remember feeling agitated, until I got to the operating room and waited for the anaesthesia to kick in. But with the chemotherapy, I've had these afraid moments on and off. They don't last very long, but they come back from time to time. Others have said they're more afraid about the nausea, some about losing their hair. I can't pinpoint one reason. So I'm thinking, I'm apprehensive about chemotherapy in general.

I have no doubt that I need to undergo these 6 cycles for the next 18 weeks until the end of February. I never, for one moment, thought of exploring other treatment options. I've heard of other people totally ditching the idea of getting chemotherapy or radiation treatments because they were too afraid of what these will do to their bodies. But unlike them, my question to myself initially was ... shouldn't I be afraid of what might happen if I DON'T do what the doctors are telling me to do? I've followed all their orders so far and because I did, I'm here, I'm better and I'm on my way to recovery. 

This is how I look at it. When it comes to how a cancer patient wants to be treated, it's to each his own. But really ... I would rather listen to the doctors on this one. I have no previous experience and I can't generalize based on the stories I've heard from other people. It all boils down to what the patient wants.

After careful analysis, I've come to realize that the start of my chemo sessions have made the cancer more REAL to me. That's probably another reason I'm nervous about the first session. Dra. Marina says it's just like any "first time". You're nervous about it but the succeeding times will be better because you already know more or less what to expect.

I'm truly blessed that my chemo sessions are all out-patient, I won't have to be in the hospital for more than 2 hours. At the end of each session, I can go home and my loved ones can take care of me. 

All that said, there's no turning back for me. It's all going to happen in 6 days. I've been praying hard and I know that I'm blessed to have prayer warriors who are doing the same.