Back to Work

First and foremost I neglected in my last post to mention a HUGE event that happened on Thanksgiving.  For those who don't know me well, I have always had long hair. I have chopped it off a few times--like when I left for the Peace Corps I cut off 26 inches.  Always donating it to Locks of Love.  As I will be losing my hair with chemo, I thought I might as well donate what I have before it goes to waste. My hair isn't currently as long as normal, just barely half way down my back. Which for me, is medium length.  My sister-in-law is a hair dresser and my 18 year old niece is in beauty school.  My sister-in-law did the cutting and my niece the color.  That's right color! I have never in my life colored my hair. It is dark brown, and aside from making it darker, coloring would require bleaching. I have always been way to anal about how healthy my hair is to let bleach anywhere near it. But, I decided as its all going to fall out, might as well go out with style.

We cut off 15 inches, more then I expected.  My sister-in-law gave me an a-line bob (not sure how you write that).  It's nice to have less hair to worry about.  Not that I ever put much effort into my hair. I have long hair so I can wear it in braids, ponytails, and buns.  :)  My niece put purple, teal, and silver stripes in my hair.  My son LOVES my hair. He is fascinated that it is colorful.  I pull it all in front of my face and say, "I can't see, where are you?" He loves it. He clears my hair out of my face and asks to do it again.  My husband, always a fan of my long hair and a proponent for not cutting it, likes it as well.  Good thing as its going to be short for a while!  Really short as it grows out.  Right now, is the shortest my hair has been since I was an infant.  Post chemo will be a new experience in how people with short hair function!!

As the title of this post suggests, I went back to work.  Not so much TO work but working. I am very blessed to have a job where I can telework.  So much is done on Skype.  We have team members in our main office in Arlington, VA, as well as in Massachusetts, North Carolina, and California.  As my immune system is low, and it is flu season, I have to be really careful. I already live with a 2 year old petri-dish, going to an office would be VERY bad.  In a 3 week chemo cycle, the middle week is called your Nadir. It is the week when your white blood cell counts are lowest and you need to be most careful. I hardly set foot out of the house all that week.  The next week I ventured to the office, wearing a mask, to sit in on our team meeting. Wearing a mask makes me feel claustrophobic--i hate breathing hot air.  But, the LAST thing I need is to be sick and have to postpone a treatment. It was nice to get out and see people.

I have to work at least 60% time to keep my health insurance, so that means I get 5 days off for each cycle of chemo.  The cycle is 3 weeks long.  This first time, working was harder then expected.  I can't be sure if its the pregnancy or the chemo, or the disastrous combo of the two--but my brain is a bit fuzzy. As both are known to make you feel a bit off mentally, the two together is just rude.  Its hard to focus--and then being exhausted and sick, well it was harder.  The third week things began to improve.  I could feel myself getting stronger.  My blood work came back from my first chemo.  My immune system  bounced back just fine--all normal.  My red blood cell count dropped a bit.  Small amount. Not because of lack of iron, but because my bone marrow is not keeping up with increased need for red blood cells.  But it was a minor drop. They'll keep an eye on it as I progress through more treatments.  It is a bit more of a concern for me, being pregnant anemia can have an impact on my growing baby.  If things get bad, I will need a blood infusion.  But that would be months down the road.

Speaking of baby, we had our 20 week ultrasound.  The baby is growing very well, is perfectly healthy. We had an extensive ultrasound, and everything checked out.  And--we learned its a boy.  A healthy baby boy.  :)  We also learned that this little boy will have more doctors appointments then me before he is born.  For now, he will be checked every 2 weeks, once by my OB then 2 weeks later by a neonatologist.  Then, after 28 weeks pregnancy he will be checked every week!  Busy busy boy.  But, I know he is in great hands.

As my 3rd week of my first cycle of chemo comes to an end, I prepare for number 2 and wonder what will be different in the next round.  

3, 2, 1 . . . . boom.

Having chemo for the first time is like waiting for a bomb to go off.  They prepare you for all the possible side effects. The ones that are almost a guarantee (exhaustion) and those that are rare (nail changes, etc).  You talk to others that have gone through chemo, you hear stories of those who were up and practically back to normal in 3 days and those who were down in bed for 2 weeks. You wait and wonder.  When will the symptoms come on? Which ones will I have? How severe will they be?  Will I be able to work next week? Take care of my son? Eat? All these questions and more swirling around in your head as you wait.

For me the first thing that hit was exhaustion.  As I said I felt fine Monday evening, but Tuesday morning the exhaustion was setting in. I slept all day, woke for a few hours in the evening to see my son, then back down and slept all night into the late morning.  It was strange to sleep that long and wake up just has exhausted.  It was an exhaustion like none other.  It was like having the flu during finals week times 10. My organs felt tired.  I didn't know I could feel my organs until that moment.  I slept all day until Tuesday evening. I then left with my little brother to go to my other brothers house for Thanksgiving.  I laid on the couch and watch my son be entertained by his cousins.  It was nice.  But still, no other symptoms were coming. I was still waiting to see if a bomb would go off.  Would my mouth break out in sores?  Would my hair fall out this treatment? Would nausea set in?  As the days progressed, exhaustion proved to be my foremost symptom.  I felt nauseated once, but in my case, that could have been the pregnancy!!

Though the nausea didn't prove to be an issue, I did have NO appetite.  It was easy to forget to eat, a first for me.  Nothing sounded good and I just wasn't hungry.  I had to force myself to eat.  Chemo burns through your protein. You need a lot of protein--which is hard because pregnancy is hard on your kidneys.  A high protein diet is ALSO hard on your kidneys. I need to find a balance of getting the protein I need to replace the cells being destroyed by the chemo, but not over tax my already working overtime kidneys.  I do this with no appetite by drinking spinach protein shakes every few days.  Spinach, blueberries, milk, and whey powder.  Not awesome tasting, but not that bad. I can usually get it down.

As the days went on the exhaustion slowly decreased, but a few minutes of activity and I would need to lay down.  What was unexpected was the mental exhaustion.  Emotional exhaustion is something I know I'll be facing throughout, but to be mentally exhausted--is a strange feeling.  They warn you about it, "Chemo fog," and it sounded a lot like pregnancy brain.  So now, my poor brain has 2 strikes against it--chemo and pregnancy.

Monday, December 2, I had to return to work.  Though i wasn't going into the office, I was able to telecommute, I really worried about my ability to work.  Plus--were there still symptoms to come? Or, was I over the worst of it?  No one can say.  

First Chemo

I realize I am LONG overdue for an update. My excuse is being diagnosed with breast cancer doesn't make the rest of your life stop. I am still mom to a very active fairly demanding 2 year old. I am still a wife. I still have a home and laundry.  I still have to work, though, clearly not full time.  I am still pregnant.  Juggling all these plus the side effects of chemo is difficult at best. I have much to say--but will spare you all of it in one post and will catch you up over the next few days.

Monday, November 25th, 9:00 am my first Chemo treatment. I was 18 weeks pregnant.  I was very nervous, mainly because it was a big unknown. My port was still very sore, and I was worried how that was going to feel.  And then of course, what were the medicines like.  The whole thing a mystery.  My husband and I showed up at the hospital infusion center and checked in. We were asked to take a seat in the waiting room.  We sat. We waited, not sure for who or what.  A few minutes later a wonderful nurse came out to get us.  She knew everything about me, and most importantly that it was my first time.  She was patient and answered every question I had with clear answers.  No sugar coating of the hard answers--which seems to be the protocol here.  I like it, most of the time.

I take 3 medicines.  This first treatment was a little different, as I would all the medicines in one sitting because it's Thanksgiving week.  After this, I will have two medicines at the infusion center and the 3rd will be infused over 3 days. I will wear a pump home and return 24 hours later to have it refilled.

The nurse cleaned the skin over the port.  The steri-strips and glue (instead of stitches) were still in place.  She used a solution to remove the steri-strips and sterilize the area.  Then, the needle.  I was very nervous but it hurt FAR less then getting a poke anywhere else.  I was very very happy, and figured it will only get better when the area is less sore.  Before they give you the chemo drugs they give you 2 powerful anti-nausea drugs, one of which is paired with a steroid that improves its effectiveness.  Once those are in, the chemo begins.  For no real reason I was nervous.  I know as the drug goes in it won't hurt, and I won't immediately feel the effects but it hits home.  I am starting chemo.  I have breast cancer and I am pregnant.   Its a realization I think will hit me at different moments over the coming months. I am still in shock, so wondering how this became my life?  How did I become one of those numbers? How did I become one of those pregnant with cancer?  There are a surprising number of us. Clearly we aren't the majority, but my oncologist has treated 6 pregnant women with breast cancer in the last 15 months alone.  A very high number, higher than average.  It concerns her.  But, how did I become one of those?  How is missing work day after day for different tests and different doctors appointments my new life? How is my baby? Will I be able to eat healthy enough to keep up with his/her needs?  Endless questions--most with no answer.

My husband and I decided to watch a movie as the drugs dripped in.  We watched on the I-pad.  The  nurse coming and going.  Part way through my oncologist came by to check on me.  She hadn't even finished the sentence, "How are you?" when I burst out sobbing. She walked away to give me a minute.  She came over and we talked for a few minutes.  It was nice. I am blessed with an amazing team.

Several people asked if I had gotten a second opinion, and to be honest it hadn't crossed my mind.  They were very clear about the aggressiveness of my cancer and the urgency with which i needed to start treatment.  But, I decided to ask my oncologist if I should have gotten a second opinion.  She said she did it for me. There are only a handful of oncologists in the area that treat pregnant women with cancer. They all talk about all of their cases and they all collaborate and work with MD Anderson in Texas.  It was nice to know.

Finally, 5 hours later, we were finished.  It won't take this long in the future, a lot of questions and discussions lengthened the process.  I felt fine.  Hungry. My husband and I decided to go to Olive Garden.  We had a wonderful late lunch and headed home.  It was a strange day.  Clearly a huge day in my life, but it passed so uneventfully it was strange.  That evening i was more tired then normal, but that could be stress or pregnancy.  I played with my son and we all went to bed.