The Chemo Plan

This week Jeremy and I met with the oncologist to get details on the next step of my treatment: chemo.  The doctor suggested starting the first round about a month after surgery, which means that August 26th will be the first day.

He explained that initially, two medications will be used.  But, I didn't take notes and now can't remember their names (maybe this is a good thing since now I can't google myself into a frenzy).  I do know that one starts with "A," and the other starts with "C".  I'll go for treatment once every 3 weeks, for a total of four treatments.  Then, it'll be time to deliver Sweet Potato!

My due date is December 20th, but it looks like baby boy will be arriving about a month earlier, sometime in mid/late November.  This decision was made by the oncologist and perinatologist, who did some math and concluded that the optimal time for delivery will be when I'm about 35-36 weeks.  By this point, the baby will almost be considered full-term, and my blood count should be at levels that deem me healthy enough to deliver. 

After the baby is born, my chemo treatments will be kicked up a notch.  A third medication will be added (something that starts with "T").  This particular med has been used with other pregnant women, but my doctor felt more comfortable waiting until the baby is born to add it to the mix.  Instead of treatments every 3 weeks, they will occur once a week for 12 weeks.  So, I'll have a total of 16 treatments between now and February-ish.

Dr. M. made it clear that the baby will be exposed to these drugs, there's just no way around it.  The main concern for the baby will be monitoring his growth, low birth weight, etc.  I feel so guilty that he has to be exposed to all of this garbage before he's even born, but I know that it needs to be done and he'll be the strongest, bravest baby this side of the Mississip!

The oncologist also reviewed the pathology report with us.  We had already gone over this with the surgeon, so there wasn't any "new" news, but I'll admit I was hoping to gain some reassurance from this doctor.  Typically, the bigger the tumor and the more lymph nodes that are involved, the poorer the prognosis.  So, I expressed my concern about the size of my tumor, telling him that it seemed really big.  Off the charts big.  

I imagined he'd say something like, "Oh, I've seen them WAY bigger!  Yours was totally average."  But instead he just shook his head in agreement and said, "Yes, it was pretty large."  

And then I asked about the large amount of lymph nodes removed...didn't it seem like a LOT? 

"Yes, there were a lot." 

Alright then...

We asked for clarification about the tests I'd had to determine whether the cancer had spread.  Because of the baby, I was only allowed to have ultrasounds, mammograms, and an x-ray.  No MRI, PET scan, CAT scan, etc.  Without being able to have these tests, how confident could he be?  The purpose of the chest x-ray was to see if anything had spread to my lungs.  He explained that the x-ray is a "good" diagnostic tool, but admitted that it's not "great."  The liver ultrasound was a pretty good indicator, so he felt confident that it didn't spread there.  But he admitted that yes, because I'm pregnant and couldn't have more advanced imaging tests, that there's just no way to know for sure.  

So this is the realization that's left swimming around in my head.  Even though surgery removed the bulk of the cancer, there's no telling whether any of it managed to escape elsewhere.  The thought of cells dividing and multiplying non-stop 24/7 while I have to wait another 2 weeks to start chemo is my current fear.  

Once the baby is born, I'm sure I'll have every scan in the book, but it's a long wait until then when I want piece of mind now.  

Near the end of the appointment we decided to go for the gold and ask the doctor his opinion on my overall prognosis. Enthusiastic cheers of "we can do this!" and "you're in good hands!" would have been my preference.  Just humor me a little bit!   But the best he could do was say that my cancer is very aggressive, and we have some work to do.

I'm trying not to let the "poor me" attitude take over.  It's completely normal that a situation like this is going to lead to a rollercoaster of emotions not just for myself, but for everyone around me.  So many people have told me how strong I am and how much they believe that I can get through this.  I just need to work on believing in myself and our Sweet Potato.  I know I'll get there, but today just wasn't one of those days.

In Other News

This week I also had a routine appointment with my OB.  I heard baby's heartbeat (still a strong 150 bpm!) and all was well in that department.

On Thursday I had another follow-up with the surgeon.  Since Jeremy went back to work this week (BOOOOOOOO), I asked my mom to come along and was happy that she got to meet Dr. A.  She checked my incisions and said everything is continuing to heal really well.  Since my drains came out a week ago, I was convinced that I felt a lot of fluid building up under my arm, but she said it's not fluid, but rather just a combination of swelling/numbness and should start to taper off as my body readjusts to the situation.  I also had some genetic testing done, to determine my future risk of various cancers.  This will help decide if it'll ever be necessary to have any preventative surgery down the road. I'm currently waiting to see if my insurance will cover any portion of it, as it's apparently quite expensive.  

My mom and I left Dr. A's office feeling optimistic, because she commented that she felt we caught things early enough and hopefully this will just be a part of my medical history someday.  Can you see why I like her so much?

I started back to work a bit this week, and it feels good to get back into a routine.  I find myself getting tired really easily, though, so I'm taking it one day at a time.

Also this week, my sister finished round 2 of her chemo treatments and she's handling it like a champ (but no surprise there).  Four more to go!