Round 4: The Home Stretch

If there is one thing I can rely on as I march through chemotherapy, it is that each round is different.  No one round has been the same with new side effects joining the party and ongoing side effects that are sometimes better and sometimes worse.  Round 4 was reliably different from Rounds 1-3. I had the same old side effects of still being bald (I know my hair won’t grow back until after chemo, but it still bugs me); sore fingernails that are turning a rainbow of pink, red and purple (a lovely sunset on each nail); temperamental taste buds that make food taste weird; brain fog; and ongoing GI problems. Joining these side effects was a new one – watery eyes.  Who knew!  My eyes are leaking non-stop.  It is so annoying.  And, then there is the fact that with each round my fatigue gets worse.  It is true that each chemo round wears your body down more and more. This time around, it took me 2 weeks before I started to feel like doing more than working and sleeping.

But the end is in sight!  Today, I am getting Round 5! And, after that, in just three weeks, I will start my sixth and final round on July 15^th.  I am not excited about another round of chemo since I am only just starting to feel good again, but knowing that in less than a month I will get my final infusion of chemo drugs, it does make the last 2 rounds less painful. 

My hope is that my 6^th round will really be my final round – meaning, I will not need more chemotherapy later.  Of course, there is no way to know if that will be the case until they open me up and check out what is going on with my tumor and take a sentinel lymph node from under my right armpit. [NOTE:  In case you are wondering what in the heck is a sentinel lymph node, I will tell you:  A sentinel lymph node is the hypothetical first lymph node or group of nodes draining a cancer.]

I do not want to jinx my hopes of no further chemo, but I did have a very promising appointment with my oncologist last week.  She felt around the area where my tumor is supposed to be and said:  “If I was examining you without knowing about your tumor, I would tell you that I do not feel anything.” I almost hugged her!  I cried tears of hopeful joy while driving myself back home.  I am not kidding.  I was really crying, and it was not my darn leaky eyes!

Of course, I will not know for sure if all of these chemicals have done their job and killed those damn cancer cells until they open me up, which, according to my surgeon will be sometime between August 5 and 26^th.  I am hoping that my surgery will be set early to mid-August as I do not really want to be undergoing surgery on my birthday (8/26).  Can you imagine?  Happy 53^rd Birthday! Your present: a double mastectomy!

With chemo winding down and a surgery date looming two months or so from now, I am shifting into wrapping my brain around my double mastectomy.  I know that my two breasts appear to be trying to kill me but losing a part of your body feels like a strange proposition.  In my case, it is losing a rather big part of my body.  The going bet in the family is that I will lose about 10 pounds.  I think that they might be overestimating the size of my chest area.  Yes, my family has a strange sense of humor.  But, if you cannot laugh about this stuff, it is only going to be harder. 

I have chosen to combine the double mastectomy with reconstructive surgery.  Perhaps I am being vain, but I do not really want to have a flat or concave chest. I would like to be able to have some kind of “womanly” chest.  I just know that it would be too difficult for me to go from a DD to a negative A (or whatever a concave chest is).  This means that after Dr. Bold is done removing both of my breasts, taking out a sentinel lymph node from my right armpit, and then sending the lymph node and tissue around the tumor to the pathologist, Dr. Wong, my plastic surgeon, will step in to reconstruct the breast area by placing “expanders” under my chest muscle with “netting” to hold in the expanders and then doing whatever magic he does to close this area up and set the stage for my new breasts.  The whole surgery takes about four and half hours.

From what I understand, I am not going to be a happy camper for awhile as I heal from the surgery. Apparently, it is difficult to use your arms after this kind of surgery.  I can only imagine the challenges posed by limited arm use! I also will have drains in me and other fun stuff.   

As much as I want to get rid of my killer boobs, I am kind of bummed about having my breasts removed and replaced by “faux breasts” that, despite any brilliant plastic surgeon’s efforts, will not look or feel like normal breasts again.  Hell, I will not even have nipples.  I am worried that I am going to look like some kind of aged and battered Barbie doll.  Seriously, I am going to be bald with weird nipple-less boobs.  If that does not remind you of what your Barbie doll looked like after several years of playing with it, I do not know what will. 

Here is a Fun Fact: if I wanted nipples, I have some choices.  I could try to save my nipples, but that would require several surgeries.  Or, I could order synthetic nipples – that was a new one for me.  The other option is that I could get them tattooed onto my new breasts.  My feeling is that if I am going to get a tattoo on my breasts, I am going to do something more interesting than nipples – hummingbirds, perhaps?  Flowers?  I have time to come up with something. 

After my surgery, I guess I have to make regular visits to the plastic surgeon’s office to have saline injected into my “expanders” in order to expand my chest muscles so that eventually the expanders can be replaced with real breast implants.  In other words, I am going through some kind of weird form of puberty again in my 50s with my breasts growing every couple of weeks.  Again, who knew what fun I had in store for me in my 50s! Once they get my chest muscles expanded to the proper size, I will have to undergo one more surgery to swap out the expanders for breast implants.  Whew.  The whole thing seems exhausting just so I can wear a swimsuit or strapless dress. But I am still going to do it because I know myself and I know that I will want to look as “normal” as possible.  That works for me.  There is no right or wrong answer here.  This is an incredibly personal decision. Someone faced with this kind of decision needs to get as much information as possible and then make the decision that works best for them. At the end of the day, the only person you need to please is yourself in terms of what happens to your body.  Period. 

Another issue presented by my impending surgery is the question of whether I should have my port removed.  Dr. Bold, my surgeon, wants the port out because he worries about the risk of infection given everything they will be doing to my chest.  But, since I have to continue my immunotherapy drugs – Herceptin and Perjeta – through the end of March, the removal of my port means that those two drugs would have to be injected into my arm every three weeks at the “infusion” center.  My oncologist is not wild about removing my port because she said that even if I do not have to have more chemo, these two drugs are still tough on the old arm veins.  After a lot of debate, I think we arrived at a compromise in which my port will come out for now while I heal from my surgery.  And, if my arm veins start to have trouble with the drugs, we can always put another port back in. 

So many decisions!

Moving on from the gory details of my mastectomy, I have been keeping myself busy when I am feeling good.  I have been baking quite a bit with scones and brownies for my mom’s birthday, brownies and salted caramel ice cream (it was so good) for Father’s Day, cinnamon crunch banana bread, and cinnamon rolls. I also used a baguette mold/baking pan that a friend sent me.  I made three baguettes.  They were very tasty and not hard to do at all.

My biggest baking success for this round is that I finally got a sourdough starter going and baked my first successful loaf of sourdough.  My first starter was a total dud despite trying to get it going for two weeks.  I did a lot more reading about starters and gave it another try.  My family thinks I am a total dork. They would ask me what I was reading, and I would say I was reading yet another blog on starters.  They would roll their eyes.  

This time I started with whole wheat flour and was much better at monitoring and feeding the starter.  I started to worry around Day 4 and 5 when the starter seems to go quiet, but I read that I need to be patient (which is not really in my nature).  Lo and behold, Day 6 feeding produced a lively starter.  On Day 7, I used ½ cup of starter and produced my first successful sourdough loaf.  I probably should have kept it in the oven another 10 minutes, but it looked good and was tasty.  I cannot wait until I do another loaf.  I wish I did not love baking as much as I do, but there is something really satisfying in measuring, mixing, and creating something that is pretty and tasty.

I guess another silver lining to this pandemic and my cancer is that I am getting pretty good at baking.  I would never had tackled sourdough or some of my other bakes if I were not stuck at home.  I am not sure my waistline is thanking me for this, but I am enjoying my time in the kitchen creating new treats for me and my family.  

I hope all of you reading this blog are doing well in this crazy world and trying to make lemonade – or lemon pound cake or limoncello or whatever makes you happy – in the face of whatever trials and tribulations are in front of you.  Know that I am cheering you on as much as you are cheering me on.  Be safe. Be well. Be happy.