My chemo diary: Day 7

 

Friday, 1 November 2019 - Over the last three months Fridays have almost lost that ‘happy’ feeling because hubby and I have been spending them mostly in doctors’ consulting rooms or in the hospital. But it is strange how one gets used to it. Very much the same way I had to get used to spending between four and six hours in the car every other day to drive to and from Parys for client meetings in Johannesburg. Some projects required me to make the commute daily. Although it is a pretty relaxing drive for most of the trip, the traffic in Johannesburg can be brutal and at best unpredictable. If you are feeling ill, or had a bad night’s sleep, or in a bad mood the trip feels extra long. And no matter how ‘good’ the day has been, one is generally exhausted by the time you get back home, especially if you have been the driver all day long. But this blog post is not about commuting; I just wanted you to know that my medical team is not 10 km away, but 130 km. This is my reason for being so anxious each time I have an appointment with the surgeon. My husband cannot quickly go home to get my pajamas if I have to be admitted to the hospital.

As has become the routine, I have an appointment with the surgeon before my chemotherapy session. When hubby cleaned the wound on my right breast during the week he kept on saying something looks wrong; he thinks he can see the implant. Needless to say it freaked me out a little and made me wonder whether I should pack an overnight bag. But two weeks ago the surgeon put stitches in my left breast’s wound right there in his rooms, so I was hoping he’d do the same if it is necessary. My surgeon, Dr Charles Serrurier, is a kind and soft-spoken man. He calls me ‘my darling’ as I’m sure he does all his patients. 

I want to write a bit about my surgeries and the healing process. My sister asked yesterday whether my surgeon did a bad job that I’m struggling so much with complications. So, I want to go back to the beginning... It is general practice that, if a patient wants to undergo plastic or reconstructive surgery, they quit smoking six months before the surgery. This is because smoking retracts the blood vessels which makes surgery difficult and it prolongs the healing process. I did not plan to get breast cancer, and therefore I did not have the luxury of six months to quit smoking before my bilateral mastectomy and reconstructive surgery. Although I have cut down my smoking over the last three months, quitting is not easy and definitely not something I’m going to do right now. My body is going through enough stress and if I quit now I am going to make myself sick. Being a smoker is therefore the number one reason my wounds are taking longer to heal.

One must then further realise that complications after surgery is pretty normal. In many cases the patient did not follow the post-surgery care regime. I have been very diligent in following it in the first four weeks after my mastectomy. But I could feel how my muscles became lazy and I decided that I’m going to start the rehabilitation process earlier than recommended, with the blessing of my surgeon I must add. I started low-impact callanetics with a personal trainer once a week. This helped not only my body, but also my mind. I also started sleeping on my side much earlier than many other patients who had undergone similar procedures, once again after getting permission from my surgeon. Could me becoming more active sooner have had an impact on some of the complications I experienced?  Maybe. But all I wanted was to get my life back to normal as fast as possible because I became depressed due to my inability to be self-sufficient. Unless you have had similar surgery you will never understand the debilitating effect it has on a person. 

The complications I experienced could have been caused by a number of factors other than my smoking and early physical activities. It is possible that I may have bumped my breast against something, causing the wounds to open up. Remember, this happened two weeks ago on my left breast, and this week on my right breast. The delayed healing on my right breast was mainly due to blood supply issues caused by the biopsy I had at the beginning of August where the surgeon cut off my blood vessels during the procedure which meant that blood flow took longer to restore after my mastectomy. This resulted in dead skin (necrosis) that had to be fixed with a third surgical procedure under general anesthetic. My surgeon is really happy with how the epidermis have almost grown to cover the entire wound, and only stitched up a small section that opened up again this last week, and sent me off with a prescription for another course of antibiotics to prevent any potential infection. 

The majority of my complaints since my cancer diagnoses have been surgery related. Other than that, I am not feeling sick. I still have no other health issues and even with cancer still have much less health issues than the average 45-year old woman. I get so upset when I speak to people who say they are also very healthy and then in the next sentence they talk about their reflux or their arthritis or their spastic colon or their asthma or their gout or their insomnia. Listen up, people! When I say I am healthy I mean that I have been tested and I have none of those health issues! None! My body is functioning optimally and is in a healthy state. It is unfortunate that a genetic mutation resulted in my cancer diagnoses, it could happen to anyone. And even though I am clinically sick with a life-threatening disease called cancer, I am not physically sick...

But, back to my chemo diary. Upon arrival at the Oncology Centre of Rosebank I visited the pathologists to have blood drawn for diagnostics. From today, before each chemo session, I will have blood tested to check my white blood cells and platelet counts. This will determine whether any changes have to be made in my chemo treatment plan over time, and is also to monitor my overall health during chemo. Once the results were available I had a quick consultation with my oncologist, Dr Ronwyn Van Eeden. We chatted about my week and how I felt after my first chemo. I think my mind played a big part in how I felt during the week (it was a bit all over the place). I monitor my blood pressure (BP), heart rate, and temperature daily because these could be indicators of underlying issues. My BP was a bit erratic this week and she said it could be because of the cortisone given to me as pre-meds to the chemo treatment. The fever and chills I had on Tuesday night was probably nothing serious because it did not last very long and could have been because it was really cold and I went to fetch extra blankets and a hot water bottle to help me stay warm. We discussed the anti-reflux medication that she prescribed, and decided that until I actually get reflux I don’t have to take the drug at all. This is good news because I do not do drugs that are not really necessary. 

After my consultation with her, hubby and I go to the treatment room and I choose a recliner chair. Out comes my iPod and earphones, a packet of NikNaks, and a Pepsi cola. Hubby pulls a chair closer and makes himself comfortable. I decided that I am not going to resist the drowsiness like I did last week... The nurse came to insert the drip and there I go - chemo session number two. The first three bags are pre-meds and took about 20 minutes to infuse and the Pepsi cola that I am drinking from a plastic bottle tastes like I’m drinking it from a can. I’m listing to music, snacking on my NikNaks while hubby is massaging my head and shoulders. The chemo drug is inserted and starts infusing. Last week this hurt really bad and I take a hold of hubby’s hand. Once again the feeling when the chemo drug enters my vein is one that is difficult to describe. First my hand goes numb, then my lower arm, and then my upper arm. It really hurts but lasts only a few minutes. Hubby gets sleepy and I send him off to the car to take a power-nap before he has to drive us back home again. It is a long drive and I am not able to take over the wheel if he gets sleepy during the trip. I feel drowsy but I don’t sleep. I look around the treatment room and it is much quieter than last Friday. Only a handful of patients are seated around the room. As I watch the chemo drug empty from the bag hanging above me I wonder when I will start feeling like a cancer patient. Not that I want to! I just want to continue with my life as normal as possible, not feeling sick, and doing all the things I like doing. And so another chemo session came to an end.

On the way back home I did not resist the drowsiness and had a really good nap. 90 Minutes was enough to leave me feeling refreshed when we arrived home at about 3:30 pm. Hubby was tired after the long day on the road and went to lie down for a little while. I checked through my emails and decided there is nothing that could not wait for Monday morning. I continued with my normal afternoon schedule - feeding the animals, playing with the dogs on the lawn, and sitting outside for a while watching their after-dinner playfulness. 

Hubby prepared dinner for us and I am still feeling normal. I have more than enough energy and it kept me going well into the night. A good nights’ sleep and I woke up feeling refreshed. The only strange thing is that I am very thirsty. But that is a good thing because drinking enough water, especially while one’s body is being filled with toxic drugs, is important to help the liver and kidney cope with getting rid of as much of the toxins as possible during chemo.

During the week I woke up each morning, waiting to start feeling side-effects from chemo because that is what everyone is expecting me to feel. I am going to continue with my life like before. I am not sick! I remain realistic that anything can change at any moment, but I am not going to sit around waiting for side-effects. And I am not going to start acting like a sick person just because I am on chemotherapy.