Three Month Follow-up with My Oncologist

As I said in my previous blog post, I have had some struggles recently. I have been trying to write about what has been going on, but it has been challenging to put it into words. I am still not prepared, but there may never be a good time, so I may as well start to talk about it.

I had a check-up with my oncologist back on the 7th of January. I didn’t write about my appointment right away because it was an unusual appointment, not my usual, “Yes, I am doing fine on my medication. My sleep is improving, as I am averaging just one night a week, where I am still awake at 5 or 6 am, instead of several nights a week. I am still fighting fatigue…blah, blah, blah…”

My bloodwork has improved to where all of my levels are normal except for my red blood cell count, it’s still low, and unfortunately, it may be my regular reading from now on. It’s not terribly low at all, 4.18, where 4.20 to 5.40 is a normal range. But being even slightly low, I can feel it, so hearing that I might not ever be in the normal range makes me terribly sad as I hate feeling this way. I asked if there is anything I can do, that some cancer patients say that they take iron to fight the fatigue. My PA said that I could take iron, but she cautioned me that it could upset my stomach, so I should take it only every other day to start if I decide to try it. She also said that she had heard that there is a liquid version that might be easier to take, but she hasn’t seen it, so she wasn’t even sure where I could get it. I am on the fence about taking iron, so for now, I am not doing it.

My PA explained that one of the essential readings they are looking at when I come every three months is my Hgb or hemoglobin. Low hemoglobin levels usually indicate that a person has anemia. There are several kinds of anemia: Iron-deficiency anemia is the most common type. This form of anemia occurs when a person does not have enough iron in their body, and it cannot make the hemoglobin it needs. High Hgb is known as polycythemia. This means you have too many red blood cells. Polycythemia vera is a cancer of the blood in which your bone marrow overproduces red blood cells. With polycythemia, a blood test also shows a high red blood cell count and high hematocrit. So low or high Hgb would be bad for me, it would mean I am either anemic, which was also a concern during my chemo treatments, or I have cancer in my blood. My Hgb is a little low, only one point from the lowest acceptable level, but nothing to worry about for now.

Now for the tough part…for most of my appointment, I cried a lot. It was hard to talk about, even with my PA, whom I adore. I kept looking away from her while I was talking and crying; I was embarrassed. Why was I crying? It was a lot of things, but mainly the fact that I have had an overwhelming feeling of guilt recently. Why do I feel guilty? As it is, it’s hard being a cancer survivor, and for me, it is tough because I have always had a great deal of empathy for people, but now it includes other cancer patients. Recently quite a few people I know, through various ways, are dealing with having a cancer recurrence. I feel guilty because I am still doing well; I am OK for the most part. They are experiencing my greatest fear, and I am feeling guilty because it isn’t me. It is also a reminder that my breast cancer was incredibly aggressive, and it could return at any time.

It is easy for most to say, “don’t live in fear, don’t worry about it,” but honestly, someone who says that to me clearly doesn’t understand how horrifying it is to go from barely needing to see a doctor to countless scans, blood draws, chemotherapy, radiation and four surgeries in a matter of fourteen months. All three of my doctors, my cancer treatments, everything I went through saved my life without a doubt, but it also damaged me in every way. I don’t know if I will ever be myself again, many cancer patients tell me that I won’t be, but I am doing everything I can to defy that future.

At the end of February, I will reach the second anniversary of my first appointment with my surgeon when I was diagnosed with breast cancer. In many ways, I can’t believe that it has been that long already, and in other ways, it feels like it has been a lifetime.

Thank you for being here; it helps to know that people care enough to read my blog, that the information I am sharing helps other cancer patients and their caregivers, and it helps me in more ways than I can say.

Fatigue & Depression

I have been going through quite a bit of fatigue and depression lately. I am still experiencing fatigue almost every day, so when I do have a burst of energy, I make sure to take advantage of it. On days when my entire body is hurting, I try to remind myself that I had my 4th surgery not that long ago, so I don’t need to be so hard on myself when I just want to rest. Resting has become another problem in the form of not being able to sleep properly. It is not out of the realm of possibility for me to be awake until 2 or 3 in the morning, sometimes even later, at least a few nights a week. I realize that fatigue is linked directly with depression, so I am beginning to understand how everything I have been dealing with within the last few months is all part of the same problem.

Not all of my depression is linked to breast cancer, but most of it is. I was talking to a breast cancer patient the other day, and she was asking me how long it has been since I had finished each portion of my treatment. I hadn’t thought about the timing of everything in a while, so as I was answering her questions, I was surprised that time has passed much quicker than I thought. It has been 11 months since my last chemo treatment, 7 months since my last radiation treatment, and 4 months since my previous reconstruction surgery; at times, it feels like a lifetime ago, but when I am having a bad day, it all seems like it happened yesterday. Even with all of that time passing so quickly, my body and mind are still healing. I have been experiencing what I thought were some of the side effects that I had at the end of chemo again, but chemo ended almost a year ago, so I am beginning to realize that some of them are symptoms of depression, as described below. Luckily, we are going on vacation soon, and the timing couldn’t be more perfect. I need a break; I need time away from everything that has been hurting my heart and soul lately, and I need to get my mind and body back on track, and I will!

Depression may be a side effect of breast cancer and fatigue is often a symptom of depression. Some people may have a tendency to depression, which treatment can make worse. At the same time, fatigue itself can lead to depression. Not knowing why you feel drained week after week, and not knowing that this abnormal feeling is normal for many people going through treatment, can make you depressed.

Treatment for breast cancer may leave you feeling sad, tired, or depressed. These feelings are complex conditions, resulting from and affected by many factors: your cancer diagnosis and treatment, aging, hormonal changes, your life experiences, and your genetics.

If you’re abruptly going through menopause 10 years earlier than you naturally would, with a quick lowering of hormone levels, you may experience feelings similar to postpartum depression.

Sadness is a natural part of your breast cancer experience, something you need to express and move through. If you don’t allow yourself to feel sad and grieve, the unresolved grief gets in the way of feeling better and getting better. You may be having hot flashes and trouble sleeping. You may be feeling overwhelmed or even debilitated. All of these factors can lead to fatigue and depression.

How can you tell the difference between fatigue, sadness, and clinical depression? The symptoms of clinical depression include:

  • an inability to cope
  • an overwhelming feeling of helplessness and hopelessness
  • inertia
  • an inability to concentrate
  • memory problems
  • panic attacks
  • loss of pleasure in what used to make you happy
  • lack of interest in sex or food
  • sleep problems

If you think you’re depressed, talk to your doctor. If your doctor doesn’t have experience treating depression, ask for the name of an accredited psychotherapist. Together you can sort out if what you’re feeling is depression or extreme fatigue. Therapy can help you feel supported and allow you to talk about what’s bothering you. Antidepressant medicines can help ease feelings of sadness and anxiety and help you feel better. An accredited psychotherapist with experience treating depression can help.

Saturday Fun

October 5th, 2019

Mood: Happy 😁

We had a busy but good day….weekly shopping, went to a local fair with a dear friend to watch a friend of ours sing, had an amazing dinner on the way home. A busy day fighting fatigue as I try to get stronger and as back to normal as I can before my next surgery.

I finally got to relax on the couch at about 11:30pm but it was well worth every minute….and yes, finally a pic of me without a wig on. πŸ’•

Taxol #12

October 3rd, 2019

Mood: Excited πŸ˜„

My last Taxol treatment went well!

Before my treatment I met with my oncologist and we had a great talk about how I have done and what my next steps are. All in all I navigated through my 16 chemo treatments very well. My side effects were minimal, mainly fatigue and slight neuropathy in my fingers during the last few weeks of treatment. There is no telling how long it will take for my red blood cell count to go back to normal, this is what causes my fatigue, but the neuropathy should disappear fairly quickly.

I told him that I already have an appointment made to meet with my surgeon, Dr. Schwartz, next week. He reminded me that I won’t need my port anymore and I assured him that I have already discussed that with Dr. Schwartz. During my reconstruction surgery he will not only do my reconstruction but he will also remove my port.

We also discussed that it is time for me to meet with my radiation doctor so she can examine me and take measurements before I have reconstruction surgery. By the time I left my oncologists office I had my appointment scheduled with the radiation doctor for two weeks from yesterday.

Last of all we talked about when I will need to see him next so he can put me on the drug I will need to take under his care for the next 10 years. We determined that I will see him around mid-January as soon as I am done with my radiation treatments.

I am so relieved that this part of my journey is over. I am ready to do what is necessary to get my health back to normal as much as possible before I have my surgery. I have been so tired going through chemo that I have not been able to work out and the steroids have caused me to gain about 20 lbs so that has not made me feel very good, especially over this last month.

My oncologist said to take it slow as far as getting back to being active and he is right….I don’t want to injure myself. So the next few weeks will be about continuing to rest, working on moving more and getting back to my regular diet which is mostly keto.

Video of me ringing the bell! πŸ’•

https://m.facebook.com/story.php?story_fbid=10217902857515291&id=1599507200&sfnsn=mo&d=n&vh=i

Taxol #11

Mood: Accomplished 😁

I have been doing OK since my last treatment. As usual I am tired, weak and run down. No amount of sleep or rest is enough at this point. I am tired of being tired….

Treatment went well today and it was quicker than normal because my nurse didn’t see that I have been getting the steroids and Benadryl mixed in a bag and given to me over a 45 minute time period. Luckily I didn’t have reactions to getting the meds quicker so that was good and it shaved close to an hour off of my time in the chair.

I have a plan in place for my month off between chemo and surgery. I will work on getting back on my treadmill and using our weight machine. The steroids have not been kind to me as I have gained almost 20lbs during my 4 1/2 months on chemo. I know that it is better to gain weight during treatment rather than losing it, but I feel yucky with the extra weight. I haven’t worked out since December so I am anxious to get back to it. I will be very careful so I don’t cause any injuries that would delay me further. I will be dealing with a weakened body so I will only walk for 20 to 30 minutes in the beginning, making sure that I am moving but not pushing it too much like I normally would do.

Getting treatment….I can’t believe it’s almost over! 😁

I have to admit, I am going to miss Thursdays off with my husband, but not the reason why. He has been my rock through what is easily the most difficult battle of my life and it isn’t over yet…..I am almost 2/3 of the way done.

Taxol #10 & My Birthday

Mood: Excited 😊

“You are in the double digits now!” That is what my oncologist said to me this past Thursday when I went in for my 10th treatment of Taxol….only 2 to go and then I will be done! 😁

Without a doubt this has been the most difficult part of my chemo treatments, 12 straight weeks of Taxol. The fatigue has been crippling at times to where I can barely get out of bed, can’t walk without my whole body hurting, can’t go up the stairs in our house without getting out of breath and my body aching. It’s hard to believe that I was running 20 to 30 minutes, 5 days a week and getting 10 flights of stairs in on my Fitbit, 5 times a week as well, before I had the energy drain from my body back in December of last year.

My energy disappearing so suddenly, felt like it happened overnight and I had a persistent cough at that time as well that was being treated by my doctor. Little did we know that those symptoms were the first signs that I was terribly sick and that I would find the first tumor in my breast a month later.

As far as my birthday goes, I can’t believe that I am 52 years old. Some days I feel much older but that is to be expected with my body and mind going through chemo. Thank God it will be over soon and then I can rest for a month before the next step….my 3rd and hopefully last surgery.

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