Chemo cycle 5b cancelled, another week delayed

First, I want to thank everyone for their prayers and positive thoughts that were put out for me. I know that the prayers worked because my WBC count went up from 1.4 to 2.3 by the time I arrived to resume treatment yesterday. Unfortunately, while my WBC count was rising, my platelet count was plummeting. The week before I was at 119, yesterday I was down to 26! In order to resume treatment, platelets need to be above 100. So, I was delayed another week. I was so disappointed and upset. The doctor and nurses are so wonderful though and they pointed out some very positive things before sending me home. First, my tumor marker - a protein in the blood that helps doctors evaluate the existence and levels of cancer - is low. It's at 14 when anything under 50 in a normal person without a history of cancer is considered normal and under 35 for someone who has had cancer. I would love to cling to this with glee but I know better than that...and I have internet access haha - so I know that there are false highs (and presumably false lows) with this measurement and that is why it's not used routinely in healthy people to detect cancer. I'm not saying I don't believe it - just that I am cautiously optimistic.

Another point made by Dr.B is that he thinks that the low WBC and platelet counts are evidence that we're "kicking the crap out of the cancer cells (and healthy ones too)" - and that's GREAT but it's also a concern (the healthy cell part) since we need for me to complete treatment and avoid complications as much as possible. So, what he said we will do is lower the dose of the chemo meds and switch me to Neupogen (the daily shot for raising WBC production) beginning next week. We're going to skip the "part b" of cycle 5 which would have been a "boost" dose of Gemzar (the secondary chemo drug I'm getting), and when I go back next week they will instead start me on cycle 6 if my platelet and WBC counts are considered reasonable for treatment. This will keep me "on schedule" and they're not concerned about me not getting "part b" since "part a" hit me (and presumably the cancer cells) so hard. *sigh of relief* Another discovery from my blood work yesterday is that I'm now anemic - right at the line anyway. The first blood draw they did had me at 9.8 for my hemoglobin (under 10 is anemic) but when they saw my platelet count of 26 they were convinced it couldn't be right and they took another blood draw from my arm, hoping that there was perhaps something strange going on at my port site. They just had the blood analysis machine calibrated so they knew the issue wasn't there. Well, the second draw hemoglobin came back at 10.1. Since it was over 10 they couldn't proceed yet with an injection that would address that but since I was 9.8 and 10.1 I was close enough that they are going to initiate the approval process with insurance to prepare for next week since I'll probably need it for sure by then. I'm not really sure what the injection is of so I'll be asking my friend Michelle (who is my chemo nurse and neighbor - love her :)) this week to remind me of the name so I can look into it a bit more. So that's where I'm at with treatment. Another rain delay haha. On one hand I'm really disappointed because I had hoped and prayed that I'd sail through this regimen the way I did the first series and stay on schedule. But on the other hand I'm glad to have a brief break now that I know how much harder these drugs are on me. I'm incredibly tired all the time. I'm short of breath going up/down the stairs or on my short walks that have tiny hills. I'm seeing the side effects of the low platelet count now when every time I bump into something I get a nasty bruise and now I'm paranoid about cooking (cutting mainly) since if I were to cut myself I wouldn't be able to stop the bleeding since my blood won't clot normally at this level. And I finally have the all over body aches and pains that tend to catch up to you when you have been on chemo for a while. It feels like soreness after running a race or working out really hard but all over, not just in select muscles that were worked out. But if I'm sitting still, in a safe place haha, I feel good (well, until a hot flash hits me but that's another story haha). Still tired, but good. I returned to work, part-time, last Friday. My team and management have been so wonderful. I'm so incredibly grateful for their support and flexibility so that I can continue focusing on my health but have something different than cancer to distract me and even make me feel useful and productive again. Certainly it's going to be a challenge sometimes with the fatigue, but I know I can manage it as long as things continue to go well with treatment in spite of these little bumps in the road. Thank you for your ongoing prayers and encouragement. I told Bob yesterday that with him being away so much, the connections I have with my family, friends and neighbors are so critical to keeping me going right now - keeping my spirits up and keeping me from falling into that dark scared place that follows me/us (anyone facing cancer) looking for a chance to take advantage of our vulnerability. But knowing that there are so many people rooting for me, praying for me, and reaching out to me encouraging me, that helps me be positive and be the tough bitch you all know and love haha :) Right? :) Because...

Carrot juice cocktails and to hell with quarantine

Ever since learning my WBC count was super low I've been on a mission to find things I can do to encourage the # to rise and to protect myself from possible infections or viruses particularly with that crazy H1N1 flu going around. Bob got on the internet in search of ways to up my number and concluded that I needed to up my protein intake which I could only laugh at since my daily intake is already between 66-80+ grams of protein (that's a lot, as recommended by my guru holistic med doc at UCLA). Then a friend of mine told me she had just seen Dr.Oz on TV talking about how carrot juice helped with the production of WBC so I got busy finding a way to tolerate adding carrot juice to my daily routine. ICK. Don't get me wrong - I love carrots. I enjoy snacking on them. But I just can't deal with drinking them. So I posted a request to Facebook requesting carrot juice recipes that would help disguise the carrot juice and I received lots of great suggestions. Today, I finally arrived at the combination I could actually enjoy - it's equal parts carrot, apple and pineapple juice. So, if it ends up not helping to raise my count I will at least not be upset about having to gulp something awful every day. But I got a late start with it, unfortunately. Since getting home from last Tuesday's appointment where I learned about my crashed WBC count, I've been on a self-imposed quarantine to avoid infections, colds, flu and the like given my increased vulnerability. It was much easier to stay home when Bob was home and could run out and get things I needed and to keep me company so I wouldn't feel isolated or lonely. But he had to head out to work Saturday morning so I faced a weekend of cabin fever with a toddler teething molars (B-R-U-T-A-L). I didn't even get to noon on Saturday before I found myself packing Cooper into the car to get out of the house. It was innocent enough, at first, as I decided I'd play it safe and stay in the car and just drive around while Cooper napped. I drove for over an hour as Cooper snoozed and then when he woke up I couldn't bring myself to just go home and found myself headed for Babies R Us to buy a play yard gate thingie. I decided that if I was going to be stuck at home we needed this thing so that we could create a big play arena in the yard which would prevent Cooper from running off to areas of the yard I didn't want him in, so that I wouldn't have to chase him since I don't have the energy - I am out of breath just carrying him up or down the stairs. Anyway, I was super careful, didn't touch the shopping cart, brought hand sanitizer and used it after touching anything, etc. I figured this outing scratched the itch to get out of the house and I'd stay put the rest of the weekend. Wrong. I managed to resist the urge to go out only until about noon and then we were up and out again and this time I headed to the food market to pick up a few things. To minimize my exposure to crowds/germs I went to a market I don't usually go to, specifically because they are never ever crowded - not even on the weekends - because they're so ridiculously expensive (Bristol Farms). I could only get a few of the things I needed because their prices were so absurd and then we headed home. On the way home I spoke with my friend who asked if it was safe for me to go out to dinner and I couldn't resist the opportunity to stay out of the house a bit longer and we headed to a local spot to meet up. We went early to avoid the typical dinner crowd and had a great dinner. Thank you, Tara, for helping me escape the miserable self-imposed quarantine tonight :). I'm hoping that my paranoia about catching something served me well enough the majority of the week and that I won't have reason to regret my little outings this weekend. Oh, I nearly forgot to mention that on Friday night I had such fun on Facebook with my online girlfriends who saw my post about the #beatcancer initiative to raise money for cancer research and they initiated a "post-off". Several of us chatted via our Facebook status updates - posting frequent updates that included "#beatcancer" to drive the fundraising effort. It was so much fun and I'm in awe - daily - of the amazing love and support sent my way from friends and family who believe in me and want to do whatever they can to help me and so many others who are touched by cancer. Thank you so much for all that you do to help me get through this. Finally, I have a special prayer request. Please pray that my white blood cell count has risen enough, and that my platelet count has remained high enough, to resume chemo treatment this week. I go back in on Tuesday at 11am pacific time, to have my blood tested and if the results are satisfactory then to resume completion of chemo cycle #5b. Thank you so much for your prayers and positive thoughts!! Love, Julie

Cycle 5b update: delayed by a week

My white blood cell count was too low to receive the 2nd half of my chemo treatment yesterday. I was so upset. The doctor had the nurse explain the game plan to me so here's what I remember - they'll have me go back in one week to test my numbers again and resume the treatment. They'll switch me from Neulasta to Neupogen which is a shorter acting drug that stimulates WBC production and I'll get that injected daily for a series of days following every treatment. The Neulasta is the longer acting version which I previously received once per cycle. So why is my count so low? Well there is a cumulative drop that occurs with chemo, and my numbers were dropping with each treatment as they expect will happen. The doc had the nurse tell me that it was actually surprising that this didn't happen sooner. Then there is the possibility that some chemo drugs just really hit you harder than others and that appears to be what is happening with the new chemo cocktail I started a week ago. Besides delaying treatment (thereby causing my treatment end date to be pushed to during or beyond Christmas and thus further delaying surgery and radiation treatment too), the other bummer about this is that I'm now much higher risk for an infection and I basically need to hunker down and stay home as much as possible to avoid coming in contact with things like the pesky swine flu (for which I now also can't get the vaccine until further notice). Bob, my sweet husband, says that I should look on the bright side and take this to mean that the treatment is working. I have to admit that when I was sailing through the first four treatments there was a fear that it seemed to be too easy to be effective. I even asked my doc a few times and he reassured me that doing well during treatment didn't mean it wasn't working. Although I'm disappointed by this news, I'm feeling OK. I'm super tired and I noticed last night that I'm out of breath by the time I get to the top of my stairs - just like I felt whenever I had to get up to go to an appointment or down the hall after a couple months of bed rest while pregnant with Cooper. The nausea I felt on days 2-6 has left me, thankfully. I wish there was something I could do and know that it was helping raise my WBC count but the nurses tell me there isn't anything I can do that I'm not already doing (eat healthy, rest, etc.) - although I know I need more rest than I've been getting these past few weeks so Bob and I are working on fixing that (for instance, we resumed sleep training with Cooper since our trip and other factors have disrupted his ability to sleep long stretches at night). In other news, I am returning to work (from home) Friday on a reduced (very) schedule. I have mixed emotions about this. I'm excited because I miss my work friends and the distraction that work will provide and get my mind off of cancer. Although part of me is worried that splitting my focus could be detrimental to both my health and my productivity. Despite my fears, I need to do it because the bottom line is that we can't afford financially the drop in pay that would result if I didn't go back at this time. If, however, we find it to become too much of a strain on me we will reassess. I don't think that will become necessary. Fortunately, I work for an AMAZING company that has been so incredibly supportive during this craziness. They have never pressured me to return before I'm ready - in fact they encourage me to take the time I need to get well and check in on me and send me encouraging messages and cards and gifts that remind me often how much they care. I am so truly blessed and grateful for their support and love, now and always.