Brookside Scheduling and Testing

Many people have asked questions about the timing of my chemo schedule and testing (thanks for caring and being interested!).

So, I thought I’d lay it out for you to show you exactly what the plan is.

May I diverge for a minute? Speaking of schedules (and schedule-keeping), I have to confess that the last 2 months of 2010, I tried to enter the seemingly omnipresent world of electronic scheduling.

I tried, actually fully committed to being hip and cool by using the calendar function on my iPad and MacBook Air.  What a disaster!  The schedules were never in sync and events would get mysteriously “deleted” (despite multiple calls to Apple Support and visits to the Apple Store).  ….and then there were the days when I accidentally forgot (happens with alarming regularity with FBC!) to charge my device on-hand, which meant that I had NO access to my calendar and consequently, NO idea if I was coming or going.

So, I am going back to my trusted Hermes Semanier Agenda, in which I can look at an entire week at a glance and hand write (in pencil), my plans for the week.  Ahhhh,  I’m already breathing easier!  No more mysterious deletions and I am no longer beholden to “charging” it.

Ok, back to the schedule:

• December 28th – Chemotherapy (1st of 6 doses) – DONE!
• December 29th – ($6000 shot of) Neulesta.  I know that it’s impolite to talk about money, but I’m still completely stunned by the cost of this (necessary) shot. – DONE!
• January 17th – Blood Draw
• January 18th – Chemotherapy (2nd of 6 doses)
• January 19th – Neulesta Shot
• February 8th – Blood Draw
• February 9th – Chemotherapy (3rd of 6 doses)
• February 10th – Neulesta Shot
• March 1st – Blood Draw
• March 2nd – Chemotherapy (4th of 6 doses)
• March 3rd – Neulesta Shot
• March 22nd – Blood Draw
• March 23rd – Chemotherapy (5th of 6 doses)
• March 24th – Neulesta Shot
• April 11th – Blood Draw
• April 12th – Chemotherapy (6th of 6 doses!!!!!!!!)
• April 13th – Neulesta Shot (LAST ONE!)
• April 14th – FBC (F-bomb BIG CELEBRATION!)

Each session of chemotherapy, held at the Santa Barbara Cancer Center, lasts between 2 and 3 hours.

There are many different ways to determine whether the chemotherapy is working, including (from breastcancer.org):

• Blood cell counts are done before each chemotherapy infusionand typically measure:
  • white blood cells, which function as the immune system cells that defend the body against foreign substances and “invaders.” If a person has a low white blood cell count, then there is a   higher risk of getting an infection. For this reason, I will be staying away from bowling alleys and kid’s “gym’s” for the duration of my chemotherapy (and perhaps beyond!).
  • red blood cells, which carry oxygen throughout the body. In addition to measuring the number of red blood cells, a test will be done to measure the level of hemoglobin, an iron-rich protein found in red blood cells that carries oxygen from the lungs to the rest of the body. (When you have low hemoglobin levels, a condition called anemia can result.) Another test will measure the  hematocrit level, which is the fraction of whole blood volume that consists of red blood cells.
  • platelets, which are cells that help the blood form clots to prevent bleeding
• Bone scans
  • A bone scan, also called bone scintigraphy, is an imaging test used to determine whether breast cancer has traveled to the bones. (Let’s hope not!) Bone scans are typically ordered:
    • at initial diagnosis (I had one), to make sure bones are healthy, as well as to create a set of “baseline images” that could be compared to any future bone scans that are done
    • during and after treatment, if you experience persistent bone and joint pain, or if a blood test suggests the possibility that the breast cancer has traveled to the bones
• Chest X-rays, or X-rays of other parts of the body
  • Before beginning treatment for invasive breast cancer, chest x-rays are ordered to see whether the cancer has spread to the lungs. The test also may be used to assess the heart and lungs before receiviving general anesthesia or chemotherapy. (I had this before surgery and was all clear-YEAH!)
  • During treatment for breast cancer, chest x-rays may be used in the following situations:
    • If a person has advanced breast cancer that has spread to the lungs, a chest x-ray is used to check on how the disease is responding to treatment.
    • For people who develop a fever during chemotherapy, chest x-rays are used to check for the presence of pneumonia.
    • If a person experiences new shortness of breath in the first few months after radiation therapy, with or without a cough, her doctor may order a chest x-ray to see if the radiation caused any inflammation of the lungs.
• MRI or magnetic resonance imaging, is a technology that uses magnets and radio waves to produce detailed cross-sectional images of the inside of the body. MRI is used to monitor for recurrence after treatment
• CT (CAT) scans: A CT scan (also called a CAT scan, or computerized tomography scan) is an x-ray technique that gives information about the body’s internal organs in 2-dimensional slices, or cross-sections. During a CT scan, a person lies on a (non-clausterphobic!!!) moving table and pass through a doughnut-shaped machine that takes x-rays of the body from many different angles. A computer puts these x-rays together to created detailed pictures of the inside of the body. Before the test, a person has a contrast solution (dye) injected into the arm through an intravenous line. Because the dye can affect the kidneys, your doctor may perform kidney function tests before giving you the contrast solution.
• PET scanscan be useful for evaluating people after breast cancer has already been diagnosed, in a number of different ways:
  • to determine whether the cancer has spread to the lymph nodes (mine spread to the sentinal node)
  • to determine whether the cancer has spread to other parts of the body, and if so, where (metastatic breast cancer).  Let’s hope not!
  • to assess whether metastatic breast cancer is responding to treatment

So, now you know where I’ll be for the next few months.  In addition to doctor appointments and chemotherapy infusions, I’m hoping to throw some big arse adventures into the mix.

It’s very important to me to be fully engaged in the healing process, while simultaneously continuing to GROW, LIVE, and have as much FUN as possible: SL (silver lining).