TGIF

So a full day at kaiser SF.... I decided that since I will be having a lot of dr's appointments, going to the dr doesn't mean I shouldn't look cute. I wore my ass kicking cowboy boots, since this whole ordeal will require a bit of ass kicking.

Also, a picture of my first ever hospital bracelet - ok so I wasn't in the hospital today, but believe it or not I have actually NEVER been checked in somewhere that required an ID bracelet like this, save a few water parks and concerts.

First meeting was with the oncologist Dr. Liu. He gave me a lot of really good information and spent 2 hours with me, an hour longer than we had scheduled. I will do my best to summarize but this does get very complicated. The cancer I have is ER positive , PR negative and they are not sure yet about HER2 status. They have sent it to further testing to determine HER2 status. The good news is that the cancer will respond to hormone treatment which means that they know what drug combos will be likely to be effective on my tumor. He said if the HER2 status comes back positive, they will add some other types of drugs to my chemo in order to attack it they way they know how to for HER2 gene related cancers.

He does need the results of my CT scan, Bone Scan and MugaScan before we can start chemo. He'll be meeting with me again next week friday (1 week from today) after we have the results of those tests to go through more details of the exact drug mix we'll be using and side effects, what to expect, timing of it all.

What we do know about my chemo now: It will most likely start the week after next, and we'll be doing "dose dense" chemo which means I get a treatment every 2 weeks rather than 3 weeks. Only because I am young and can withstand it. However, that also means that as I go through chemo, they will be regularly testing my white blood cell count - low white blood cell count means my immune system is very low. I will have to give myself injections of GCSF to boost my immune system. How many/how much will depend on my white blood cell count as we go along.

He is recommending AC-TH (the H is for hercepton which is a hormone to treat HER2 positive cancers, so that H may get taken off if my final tests come back HER2 negative). I will get more details of the effects and side effects in my next meeting with him. I will be doing 4x doses of the AC mix and another 4x doses of the TH mix, which would mean 8 total treatments every 2 weeks, four months total. After that, they usually wait 1-2 weeks and then do the surgery.

Still waiting on the MRI next week to stage the cancer - this will not have as much of an effect on the chemo as it will on the surgery. MRI will tell us how big the tumor is - if the tumor is more than 5 cm or has spread to more than 3 lymph nodes I will have to do radiation as well after surgery.

We did also have a short conversation about fertility today, looks like about 50% of the time, chemo with these hormones will send a person into early menopause. Normally they would recommend saving eggs, but that is a process that takes a couple of months and they do not want to wait that long to start chemo. So, he referred me also to a reproductive endocrinologist to discuss what I can do to best preserve my fertility. However, just good to set the expectation that this chemo may leave me not able to have kids.

The other big blow was that my oncologist was recommending strongly for me to take 6 months off work. Now, not sure if I will need to do that, or if I can afford to do that. He did give me the paperwork to start that process, but I am going to wait a little while, maybe after my first treatment to see how I feel from it, to determine if I can just do a combination of a few days off and/or working from home or if I will have to do full blown time off.

There was a lot more info I got, but for the sake of keeping this manageable, just ask me in the comments if you have more questions - next major update will be next Friday when I meet with the oncologist again - that will be a planning session for starting chemo.

The CT scan was cake although they give you an IV and I learned after he stabbed my right arm and didn't get a vein that my left arm is my better arm for a vein for an IV. Apparently that is out of the ordinary for someone that is right handed. I guess add that to the list of out of the ordinary things lately! :)

Love you all,

Amy