Breast Cancer and Needles

One of the most unpleasant things about having been diagnosed with cancer, besides the obvious, was the number of times I was poked with needles throughout the treatment period. First the blood tests, then the needle core biopsy, the vaccinations, the IVs, the self-injected Neupogen and then more blood tests.

The needle core biopsy was the least fun. The radiologist shot a hollow needle into the tumor at least six times from some type of needle gun (like a nail gun). Cores of tissue samples were extracted from the tumor to be sent to the lab for analysis. Even though the radiologist numbed the area first, it was still painful. In fact, it’s been over a year since the biopsy and my breast is still tender.

When the results of the biopsy came in surgery was immediately scheduled to remove the tumor, which meant more blood tests, a flu shot plus a pneumonia vaccine.

The day of surgery an IV needle was placed in my vein and another needle was used to inject a radioactive dye in my breast for the sentinel node biopsy. The hospital staff kept me supplied with warm blankets and gave me lots of attention. Just before surgery the nurse ran something through the IV to relax me. I felt pretty good by the time I was wheeled into the large white operating room.

After waking up in the recovery room I had to wait for a couple of hours until the anesthesia wore off before I was released. At home the next few days I experienced headaches from the anesthesia, but otherwise I felt great.

A couple of weeks later I was feeling very optimistic while I was waiting for the results of the biopsy. When my surgeon, Dr. Carmen Hudson, walked in with a serious look on her face and asked me if someone had accompanied me to my appointment, I knew something was up.

She first apologized for not getting a clear margin when she removed the tumor and informed me that I would need another operation that would involve removing my areola and nipple. I told her that it was only decorative anyway since I'm not planning to have any more children. She laughed and then got serious again. She said, "I'm so sorry. The biopsy revealed a microscopic amount of malignant cells in one of your lymph nodes."

“Does this mean that I’ll have to have chemotherapy?"

She said, "Yes, most likely." She told me that the standard course of action was to also remove the remaining underarm lymph nodes for further examination to make sure that they were cancer free. However, she said that she didn’t think it was necessary since the malignant cells in the sentinel node were microscopic in size and the other two nodes were cancer free.

In my research, I read that often times malignant cells found in the sentinel node, especially if microscopic, can travel there via the needle during a needle core biopsy. I also knew that chemotherapy was usually recommended if cancer traveled too far from its point of origin.

More blood tests, another IV, more needles.

This time, I requested a twilight anesthesia instead of a general because the general took too long to wear off. Dr. Hudson scheduled the "clean-up" surgery (her words) in Kaiser’s out-patient clinic at St. Vincent’s hospital, instead of the main operating room.

Similar surgery, but without the frills. My next pre-surgery room consisted of a bed with drapes on a track for privacy in a barracks-like room.

My nurse anesthetist was a short, stocky, very mature German woman who spoke with a thick accent. Earlier, Diane spotted her in the hallway pounding on a door saying, “Open ze door. I need drugs NOW!” We later figured that she was really a closet comedian, using her demeanor to entertain the patients.

After I was given something to relax me (another needle) my nurse anesthetist told me to walk to the operating room. When I asked, “Aren’t you going to wheel me in?” She said,“Nope, you can still valk, can’t you? So get goingk and HURRY. Ze docta est r-r-r-ready.” It was like a scene from a Frankenstein movie. I wondered if I had made the right decision and started to miss the all of the attention I got at the main hospital.

I walked to the operating room and climbed up onto the table. A nurse hooked me up to an IV and I slept through most of the surgery, only waking up once to comment on the beautiful butterflies flying around the operating room.

I woke up again in the recovery room, which was the same "room" I was in prior to surgery. As soon as my eyes opened Dr. Hudson released me and Diane drove me home.

A month later and a couple of days before my first chemotherapy treatment, I had more blood tests and the oncology nurse weighed me to determine the maximum amount of poison my body could handle.

The chemotherapy regimen my oncologist ordered for me was Dose Dense ACT. One of the greatest benefits of the Dose Dense ACT regimen is that it’s given over the course of four months instead of the usual six. This reduces the chances of side-effects, primarily cardiovascular damage. The dosage is given every two weeks rather than every three.

Since two weeks isn’t enough time for white blood cells to regenerate enough to be in the safe range, I had to give myself injections of Neupogen for several consecutive days beginning a few days after my chemotherapy treatment because it was during this time that my immune system was its lowest.

Before each chemotherapy treatment, I had to have a blood test to make sure that my white blood cell count was high enough to proceed with the chemotherapy.

The day of my first chemotherapy treatment I opted to have the chemo cocktail delivered via a vein on the back of my left hand rather than having a port installed in my chest. The ports can sometimes cause infections.

Minutes before my first chemotherapy treatment I was given steroids to help me tolerate the chemo drugs. It caused my legs to be restless and I couldn't lie still, so I was given another drug to counteract the first one.

The nurse found a good vein right away and inserted the IV needle. She set the chemo drip to enter my vein slowly so that it would be easy to stop, should I experience a bad reaction to the drugs. It went smoothly and so I scheduled another appointment.

Before they released me I was given some anti-nausea medication, which didn't help me keep down the rich sauce-laden French food that I ate following the chemotherapy treatment.

A few nights later I had to start the Neupogen injections and asked my sister, Diane, and son, Lance, to watch, to make sure that I did it correctly. I took the Neupogen out of the refrigerator 30 minutes prior to injecting the drug and filled a disposable syringe after the Neupogen warmed up. I pushed the air out of the syringe, sterilized my chosen entry site with alcohol and held my breath. Pinching the fatty skin between my thumb and fingers, I inserted the needle at a 45-degree angle, then slowly pushed the plunger of the syringe until the Neupogen disappeared.

The little fatty ring around my waist was my first point of entry... and second... and third, but when I began to worry about the possibility of hitting a vital organ, I switched to a new site... my not-so-fat thighs.

During my second chemotherapy treatment, I was assigned a different nurse. After two failed attempts to insert the IV needle properly and causing a vein to collapse, I asked for another nurse, which I continued to do for each of the remaining chemotherapy treatments.

During the Taxol stage of the chemo treatment, I came down with pneumonia, despite the vaccination, and had to have more blood tests, plus an x–ray of my chest, and a prescription for antibiotics. When the bottle of antibiotics was empty I had another blood test to make sure that my immune system was strong enough for more chemo.

I still can't stand the sight of a needle, but compared to chemotherapy, an occasional blood test is a piece of cake. The Neupogen injections were inconvenient but necessary to keep my white blood cell count up. I imagine that from now on needles will always be a part of my life (at least for routine blood tests), like it or not.

Chemotherapy and Nutrition

During the first two months of chemotherapy (the AC portion of the 4-month ACT regimen) it was difficult to get the nutrition I needed because I was constantly nauseated. The anti-nausea medication Kaiser Oncology pharmacy gave me helped to curb the queasiness, but my appetite was still suppressed from the chemo cocktails. The only foods I wanted to eat during that time were bread & butter pickles and mashed potatoes. I even CRAVED bread & butter pickles and managed to consume two giant jars in just two months. Sometimes I would wake up in the middle of the night hungry for bread & butter pickles and couldn’t get back to sleep until I made a trip to the refrigerator. What’s interesting is that I didn’t crave them before chemotherapy, or after.

I lost 10 pounds those first two months, but gained it all back, plus a few during the T (Taxol) part of the regimen. I was so happy to regain my appetite that I ate everything in sight.

After the chemotherapy and the radiation treatments ended, my eating habits were not as good as they should have been. Even though I generally follow a healthy diet, I found it hard to eat as many fruits and vegetables as is recommended to prevent a recurrence of breast cancer. The solution? A Vitamix Blender. It has a very powerful motor that won’t bog down and can liquefy fruits and vegetables in just seconds. I found it much easier to drink my fruits and vegetables all at once rather than eating them throughout the day. However, I still use a smaller blender for making an occasional smoothie.

The Vitamix blender was first introduced to me by a doctor who is also a cancer survivor. He said that he didn’t have time to nibble on vegetables all day, so he bought the blender and now can conveniently drink all of the vegetables he needs for the day in one or two glasses of juice.

I bought my blender at Costco after watching a Vitamix rep demonstrate all of the cool things it could do. The price was much lower than what I found on the Internet, however, I later learned that Amazon.com has the lowest prices for the Vitamix blender Vitamix 5200 Series Blender, Black and other items as well. I thought that Amazon.com only sold books and DVDs, which is why I didn’t check their prices earlier.

If your mouth is sore from chemotherapy and you have difficulty swallowing food, you might find it easier to drink your nutrients during your treatment regimen. Any blender or juicer would probably be fine. I happen to own a small blender, a juice extractor, and a juicer, although I prefer the Vitamix blender because the motor is very powerful and it’s easy to clean. Plus, the Vitamix container holds a lot of fruits and vegetables, so I can make up a large batch of juice at one time.

Is it a chemotherapy-induced heart attack or just gas?

Halfway into my chemotherapy treatments I had a real scare. My granddaughters, Opal and Violet, were visiting as they usually do on Friday nights. We had just finished eating dinner and were getting ready to watch a movie on TV when all of a sudden I felt a sharp pain in the center of my chest. It went away after a few seconds, but came back whenever I bent over.

I called the Kaiser Oncology department and the after-hours nurse told me to hang up and call 911 immediately. When the operator answered she told me to stay on the phone until help arrived and to have my granddaughters turn the lights on and off rapidly and continuously so that the paramedics could find my apartment without delay.

I could see that Opal and Violet were frightened. I told them what was happening and not to worry—that it was probably nothing, but the doctor just wanted to make sure.

Within minutes 6 handsome men in uniform were in my living room taking vitals, administering oxygen, and hooking me up to an IV. The paramedics said that my granddaughters could not ride in the ambulance with me, so I called my friend, Seamus, to come over and watch the girls. One of the firemen offered to stay with the girls until Seamus arrived (talk about great service).

It was a busy night at the hospitals. Kaiser and St. Vincent’s hospitals were both full and so I was diverted to a hospital in nearby Tualatin.

The tests turned out fine and it wasn't a heart attack, but gas, most likely caused from the mocha chocolate freeze I drank earlier in the day. I’m not used to drinking caffeinated drinks, so I may have had a strong reaction to it. The attending ER nurse told me that the hospital he worked at previously gave their cardiac ER patients anti-acid tablets upon admission to rule out the possibility of gas before they started any extensive cardio testing. He said that the symptoms can be the same.

When I returned home my son and granddaughters were very happy to see me and started laughing when I told them my chest pains turned out to be just gas.

Tragic or near-tragic events can be the fodder for a creative mind. Opal wrote the following poem about her experience that night:

Grandma Scare

The sky turns black
I turned on the TV looking for a movie and find it!
Garfield 2 and the Tail of Two KittiesThe movie started
20 min. and grandma calls 9-1-1 why
I turned around
My heart starts to pound
I see her aching
I flickered the lights
My sister helping

The ambulance came
They did tests
My sister and I are shaking in fear
Then her friend came to watch us
While my grandma goes to the hospital
I watched the rest of the movie in fear
When she came back
I was happy
And it was all from caffeine
My dad came and the day ended.

Opal Dillard, Grade 5

Opal’s poem was published in a book containing the poems of select young poets from elementary schools throughout the west.

That night was a scare for us all, but fortunately it had a happy ending. My tip to those of you who are experiencing any chest pains is to call 9-1-1 immediately, even if you think the pains are caused from gas. Every second counts if it turns out to be more than just gas. Heart attacks can be a side-effect of chemotherapy, so you should always be concerned if you experience any pains out of the ordinary.

If you have neuropathy from chemotherapy try Earth shoes

A possible side-effect of chemotherapy is peripheral neuropathy. One of the symptoms is numbness or tingling of the hands and/or feet, most commonly affecting the fingers and toes. The neuropathy may diminish or even disappear completely after several months, but for some it may last forever. Individuals at greatest risk of peripheral neuropathy are those who have preexisting peripheral neuropathy from diabetes, alcoholism, severe malnutrition or previous chemotherapy.

My symptoms included numbness and tingling in my big toes. It may seem slight, but the neuropathy prevented me from wearing closed-toed shoes. Any pressure on my toes caused from pushing my feet forward, sent me through the roof. I tried some athletic shoes in a size bigger than I normally wear, but even that didn’t help. I wasn’t able to wear the shoes without experiencing some discomfort.

Fortunately, I could wear open-toed shoes in Palm Desert where I would spend the next 5 months. I started out wearing sandals on my early morning walks, but really needed a shoe with more support.

It was during my first visit to Idyllwild that I discovered the Earth shoe. Remember the Earth shoe from the 1970’s? Well, it’s made a comeback and is now available in several different styles. One of the company’s marketing tactics is to display posters showing several well-known celebrities who wear Earth shoes. I guess the message is to make you feel “cool” when you wear them, instead of like a “hippy” or “earth muffin.” I imagine that with all of the baby boomers turning 60+ the Earth shoe will become more popular than ever.

The charming owner of the Idyllwild shoe shop was a very knowledgeable retired Podiatrist from England. When I watched how he treated his customers, I knew I had come to the right place. After he slipped the Earth Shoes onto my feet I didn’t want to take them off, they were so comfortable. With the negative heel technology, there was no pressure on my toes. My posture also improved because the shoes forced my body into proper alignment.

I ended up buying some open-toe sandals like Earth Origins Women's Sedona Brown Sophie 7 B(M) US and some comfortable walking shoes similar to Earth Shoes Rocket - Womens

and some closed-toe clog-like shoes Kalso Earth Shoe Women's Black Patent Solar 8 B(M) US for Oregon. Now I find it hard to wear any other type of shoe, even though my neuropathy has diminished.
                                    

My tip to others who suffer from peripheral neuropathy is to at least try Earth shoes. They take a little getting used to because the heel bed is lower than the toe bed, which forces you to stand more erect. Even if you don't have neuropathy, the Earth shoes can help prevent foot problems and are great for people who have to stand on their feet all day: nurses, doctors, teachers, waiters, chefs, etc.

Bring The Rolling Stones to Chemo

My therapist and other breast cancer survivors told me that it helps to meditate and to practice visualization or guided imagery during chemotherapy treatments. I was also told that acupuncture helps, as does aromatherapy, wearing certain healing gemstones and listening to soft healing music.

I tried everything and do you know what helped the most? The Rolling Stones.

Guided imagery was soothing, but my impatient mind kept wandering. I did bring healing gems with me to chemo, but always had trouble finding them because they were usually buried in the bottom of my bag somewhere. Acupuncture wasn't possible because Kaiser no longer allowed acupuncturists in the chemo treatment room as they took up too much space—space that was needed for more chemo beds.

When I first entered the treatment room and saw all of the older patients (where were the young ones?) lying on beds and sitting on reclining chairs, hooked up to chemo drip bags and staring off into space, I wanted to rebel. I certainly wasn’t as old or as sick as they all appeared to be.

Nope, no soft meditative elevator music for me. I wanted the Stones. It was my form of meditation. It carried me back to The Rolling Stones - Bridges to Babylon tour that I attended at the Seattle Kingdome with my cute date, Clackamas County Sheriff’s detective, Tom.

Tom was a classy cop who wore custom-tailored clothes from England, drove his BMW way too fast and liked Bombay Sapphire martinis with a twist. He also played the bagpipes in a national police piper band and did a tour of duty in Iraq with his National Guard unit.

When we arrived in Seattle I changed into my Rolling Stones concert clothes-- a short black leather skirt, black leather boots and an animal print top. Tom took one look at me and said, “Wow, I didn’t know you were going to dress up so much.” Maybe it’s because he worked vice and thought I looked like a hooker, I don’t know, but after seeing the surprised look on his face I decided to change into something more conservative.

The Kingdome was full of hip people of all ages who came to see the Stones-- parents with little children, teenagers, old hippies, and several conservative-looking 25-45-year-olds. We had fifth row seats, slightly off center stage (the tickets were purchased over the phone from a scalper who lives in Chicago).

When Mick walked out the crowd went crazy. He still had more charisma oozing out his trademark mouth than Angelina Jolie, and his energy level was amazing. He jumped around the stage like a 25-year-old and didn't slow down until the show ended. What else I found amazing was how Keith Richards managed to endure years of late-night partying and body abuse. He may look like he’s ninety, but he still knows how to give the audience what they paid for.

About halfway through the first set a sweet-smelling cloud starting filling the stadium and I wondered how so many people could be smoking pot in such a closely guarded enclosure without being caught. The reality was that nobody cared, including my date. After all, it was the Stones.

Speaking of pot, a couple of acquaintances offered to be my medical marijuana providers—“to help me get through chemotherapy.” Needless to say, they were very disappointed when I turned down their generous offer. Not that I didn’t appreciate their “kindness”, it’s just that I’ve never liked smoking anything. Besides, I already had breast cancer and didn’t want lung cancer too.

I’ve heard that marijuana really does help some patients tolerate chemo treatments better, especially those in later stages of cancer, so I’m not discouraging chemo toking—it’s just that it’s not for me. The anti-nausea drugs Kaiser gave me worked just fine.

My suggestion to other chemotherapy patients is to try anything that works for you because as you’ll find out, chemo isn’t a party. As for me, I’ll take the Stones over Yanni anytime.

If you've lost your hair invite a bald guy over

Even though my friends and family told me how beautiful I looked with no hair --- that I had a great-shaped head and should go bald all the time --- it didn’t seem to matter what they said. Whenever I looked in the mirror I saw an alien.

I decided that the only way I would feel better was to invite my bald friend, Norm, over because he might understand what I was going through. Norm started losing his hair at an early age and has been shaving his head ever since. When I first met him a few years ago at the Portland Art Museum I thought his shaved head looked sexy and exotic. Maybe he would think the same about mine.

Norm’s my buddy and we have a lot in common. We’re both techno-nerds and perfectionists with matching IQs and now, matching heads. Besides everything else he’s done for me, I know that I can always count on him for a good laugh, and if ever I needed one, it was now.

Well, my idea worked. As soon as I opened the front door and saw him standing there with his bald head and big grin I felt better already. Two glasses of wine later we were cracking up laughing as we compared our shiny domes in the mirror. One noticeable difference was our head size. Was his head really big or was mine just small? If we were seen in public together people might think we had been cast in a sci-fi movie.

The important thing is, he made me feel normal again. He was kind, loving and funny and he told me that my bald head was beautiful --- that I looked great with no hair. Yes, I know it was the same thing my family and friends told me, but it sounded different coming from him (one baldy to another).

So my advice is, if you’re feeling a little depressed because you’ve lost all of your hair due to chemotherapy, invite a bald person to dinner. I promise it will cheer you up.

Use a lint remover roller to test for chemotherapy hair loss

Not quite sure if you’re losing your hair yet? One way to find out is to use a masking tape lint remover roller on your head. If you end up with hair on the sticky side of the tape, most likely you’re losing your hair.

A couple of weeks after my buzz job I mentioned to my sister, Diane, that I didn’t think my hair had started falling out yet because I hadn’t seen any short hairs on my pillow or clothing. I told her that maybe I should use some scotch tape on my head and see if any hair comes out on the sticky side of the tape. She said, “Why don’t you use a lint remover instead? It would be easier and faster.” What a great idea! I got out my masking tape lint remover roller and began rolling it all over my stubbles. Guess what? There were short hairs all over the tape. Then I became obsessed with removing all of the hair that I could, so for the next half-hour and 20 strips of masking tape later I ran the roller over my head, each time pulling out more stubble. Then I began to worry that my hair may not grow back at all if I continued pulling it out by the roots, so I put the roller back in the drawer. This ended up not to be true, in fact my hair grew back thicker after chemotherapy.

There might be other ways to determine whether or not you’re losing your hair, but the above method worked for me. If you have another process that worked for you, please share it.

Get a buzz job before your first chemotherapy treatment

My oncologist told me that I would start losing my hair approximately 2.5 weeks after my first chemotherapy treatment for breast cancer and that I should get my head shaved before that time because it would be less traumatic than watching my hair fall out in big clumps. Since I was starting a new job the day after my first chemo treatment, I decided to get my head shaved right away. I certainly didn’t want to be with a customer when a clump of hair dropped onto my shoulder. How would I explain that?

So I went to my hairdresser (the same one who cut my hair and dyed it red) and told her I was ready for my first buzz job. The transformation from fiery redhead to GI Jane was interesting, to say the least. I watched as my new red ringlets dropped on the floor all around me. Where did all that hair come from? She swept it up into a pile while I stared at myself in the mirror. The most interesting part of the process was seeing myself bald (well, almost bald). She hadn’t shaved my head completely, so stubble remained. Other than looking like a boy, it wasn’t that bad. I could handle it, besides I had my new sexy straight wigs. I always wanted straight hair and now I could have it.

My advice to breast cancer patients is to have your head shaved and wear a wig or go completely bald and wear large hoop earrings. Forget wearing head scarves and turbans unless you want to look like you're undergoing chemotherapy. If you shave your head, you'll just look trendy or hip, in fact you might even want to get a tattoo. When you wear a wig, if it's a natural-looking one, people will just think that you've changed your hairstyle.

Try a new radical hairstyle before you start chemotherapy

When I found out that I was definitely going to lose my hair because of the chemotherapy cocktail that I would be given, I decided that I wanted a new hairstyle --- something radical that I would be afraid to try under normal circumstances. I scheduled an appointment with a hairstylist and told her that I wanted her to cut my hair short and dye it red.

It may seem silly, since I would be losing all of my red hair in just a few weeks. Actually there was no better time because what if I didn't like my new do? Not to worry! I wouldn't have it very long.

My hairstylest performed her magic and after the initial shock wore off I found that I really did like my new short curly red hair, in fact I loved it! It wasn’t auburn or strawberry blond, burgundy or chestnut with red highlights. It was pure red, bright and warm red-red. I couldn't wait to show it off. It gave me something to look forward to, for a change.

My advice to other breast cancer patients who are facing chemotherapy:
If you have ever wondered what you would look like in a different hairstyle or hair color, now is the time find out. What have you got to lose besides your hair?