Wednesday, October 27, 2010

My Adventures with Percocet

Tuesday was my very worst day yet.  In order to get relief from the pain in my legs, feet and hands Dr. Califaretti prescribed Percocet.  As some of you know this is a combination narcotic Oxycodone and non narcotic pain reliever Acetaminophen.  My first pill on Monday night seemed to work immediately in the pain department but I knew something was up when I lost all my dinner.  David cooked a lovely piece of salmon - what a shame it ended up in the toilet.  I still managed to keep fluids down.  At bedtime I took another pill and loaded up on Senokot and Colace (narcotics give you constipation - who knew?) No pain all night - that was great. By 6 am the pain was back so I popped another pill and some more who know what.....At 9 am I got out of bed and decided to have some breakfast.  I was feeling rather nauseous and my Italian background dictates that I need to eat and soon.  I also took some of my nausea pills which are to be used when the feeling hits.  After my first round of chemo I didn't need any of these.  I gobbled down bowl of something nearby - Apple Cinnamon Cheerios.  Not the best choice but I needed something cold and sweet.  That didn't stay long.  Rest of the day was spent on the couch feeling very poorly and any attempt to drink fluid or eat something did not work out.

By the mid afternoon and feeling out done by medication I put in a call to Pat, my nurse coordinator.  After she got the story she consulted with Dr. and got back to me within the half hour.  I knew they could feel my pain.

They felt I was experiencing a side effect of the Percocet - nausea and vomiting.  My most favourite of all the side effects.  Rather than give me another prescription for either nausea or pain she asked me to just keep taking sips of water to stay hydrated and see what tomorrow will bring.  I was all for that.  I decided I could live with some pain instead of taking another Percocet.

By dinner time I could keep down some mashed potatoes and a bit of chicken.  No more bouts of vomiting and I didn't feel so nauseous.  However, the pain was back but I felt could persevere. 

By this morning I am feeling my old self and the pain in the legs is decreasing all on its own anyway.  No more Percocets!

Tuesday, October 26, 2010

More news following chemo session 2

Throughout the weekend, I only had to deal with fatigue.  The Gabapentin painkiller that had been prescribed was doing a nice job.
On Saturday night, Pat and Suzanne visited for dinner.  We hadn't seen them in a few weeks so it was good to catch up and hear about their trip to the Netherlands and Germany.  We may hear from them more often now that Rob Ford has become Toronto's mayor!  

Also, thank you to Jill and Michael for dropping off the therapeutic goodies.

On Sunday, I felt pretty good and we had a nice visit in the afternoon with Katherine and Cam.

By Monday morning, my condition had worsened.  The Gabapentin wasn't doing its job and I had pain in my hands, lower legs and feet.  I called the hospital and they prescribed a new serious painkiller (Oxycodone).  It has taken away the pain, but it has its own side effects - such as feeling nauseous all the time.

I'll write again in a day or two when I feel better.

Friday, October 22, 2010

2nd Chemo Treatment

Wednesday's visit to the hospital for blood work and consultation with Dr. Califaretti went very well.  All the blood counts were normal.  Some issue with the liver but she expects this as the liver is working very hard.  Will get back to normal after treatment ends.  Oh and I have lost about 10 pounds.  This is mostly from the fluid in the abdomen (ascites) and maybe some of my own weight due to a lack of appetite.

So the next day on Thursday I had my 2nd chemo treatment.  This time around it went much smoother.  My pre-meds contained additonal drugs to counter the effect of the benedryl and hydrocoritsone to counteract the effects of the Taxol from the last time.  The effect on me is that I slept much of the time I was there.  Sometimes the nurse had to wake me to check my vitals.  I was very drowsy. 

Corina and David were with me in the morning and it was a good thing they had books to pass the time.  Mom came in the afternoon and I remember waking long enough to say hello and then passed out.  Before long it was 3:00 pm and Mom was gone and David was back.  I wasn't awake when Mom left.  It was time to leave but I had to fully wake up first.

Today is Friday I feel good and energetic.  Did some email, housework and cooking. This was a similiar experience last time as well.  But what will the weekend bring ?  I sort of crashed the last time.  We shall have to see.  Oh the hair thing....this morning so much fell out during my shower I had bald spots so I asked David to shear off the remainder at 1/4 inch.  Much better.  And no I am not going to show you any pictures.  : )

Look Good Feel Better

Mom and I attended a 'Look Good Feel Better' workshop this past week on Tuesday, October 19th.  This was a great experience.  Every person in cancer treatment were teamed up with a cosmetician and a box full of cosmetics and toiletries.  I think this was worth about $300.  It was just like Christmas.

These items are all donated by the  CANADIAN COSMETIC, TOILETRY AND FRAGRANCE ASSOCIATION FOUNDATION.  The products are name brand items like Estee Lauder, Yves Rocher, L'Oreal, Mary Kay, Avon, Clairins, etc.  You get the idea.

The instructor described the process of facial care and then make up application.  All the instruction is based on our condition such as no matter what skin type you were before treatment you are now 'dry and sensitive.'  I have noticed this but thought it was welcome change from my oily skin. 

Our cosmetician would then show us how to apply all various creams and lotions and potions in a clean and sanitary manner.  How many of you stick your fingers into a jar of face cream?  All too many of us I am sure.  Should use a small plastic paddle.  How often do you wash your brushes?  Ha... I know you don't.  I don't very often.

Then we would apply the concealer, foundation, powder and eyemake up in a clean sanitary manner.  Much of this involved placing the damp type products on the back of your clean hand and applying with clean fingers.  With a foundation smooth out the product with a clean sponge.

Anyway lots of good clean fun.  And good advice.  There was also another woman who talked about buying wigs and how to fit them properly. 


Speaking of hair loss it is a lot like the leaves falling from a tree.... slowly first, then faster and all of a sudden there isn't one left on the tree.  I am about 3/4 of the way.  What a mess in the bathroom!

The ladies from work came to visit on Tuesday night.  I was looking good!  First time I've had makeup on for about a month which is so unlike me.  I am resolved to put on make up everyday even if I am not going anywhere.  You just feel better when you look in the mirror. 

A great Chinese dinner and some wine made the evening quite enjoyable.  Hope we can do it again soon!

Monday, October 18, 2010

Week of October 12th

This was a quiet week.  Lots of reading, watching movies and staying put.  Medication for pain ran out Tuesday and luckily I do not have any pain in my legs and joints.  I pretty much felt normal and have energy which is ironic as this week was the period of time after chemo where I was most vulnerable to infection.  I have been doing a little cooking but the kitchen is really David's domain right now.  My mother has been providing welcome additions to my diet as well.  Care packages of homemade chicken soup, gnocchi, homemade pasta, etc.

My hair is now starting to fall out.  Oh joy.... My scalp is tender and if I gently tug at my hair then mittfuls of hair come out.  My pillow at night is full of hair.  I am prepared with my new wig, plenty of scarves and several chemo caps that were made for me by the spouse of a former colleague.  Very thoughtful!  Thanks Heather and Bill!

On Saturday morning I went to Hope Springs to take a Gentle Yoga class.  All the participants are cancer survivors (or in treatment).  This is the most exercise I've had in 2 months and it felt pretty good.  Remember up to my first chemo treatment I looked about 8 months pregnant and walking was a major feat.  Now I am looking more like 5 - 6 months.  I have lost some of that ascites from my abdomen and it feels much better.  Less pressure.  Sleeping is easier as well.  But I still have to remember not to do too much as then I get exhausted and need a nap.  What a life.....

Next appointment at hospital is this Wednesday, October 20th.  Blood work will determine if white blood count and platelets are at normal counts so that I can start the whole cycle again on Thursday with my second chemo treatment.  I am confident all will be fine.

Tuesday, October 12, 2010

Thanksgiving Weekend!

 Hope everyone had a great weekend!  For my American family, our Canadian Thanksgiving Day fell on Columbus Day this year.  This does not happen every year.  It reminds me of the time my Mother and I went to visit Franca in NY on the Thanksgiving weekend in 2007.  At that time it was also Columbus Day.  Every year NYC has a Columbus Day parade down 5th Avenue.  Franca's husband is John Sullivan and he works for the Corrections Dept in NYC.  Corrections and the Corrections family always marches in this parade so my mother and I did as well. It was an exciting day!

Mom and I and John
Only picture I could find with Franca (white shirt)


5th Ave. looking south.  See the Empire State Building!
5th Ave. looking north
Our Thanksgiving weekend at home was quiet.  Lots of football on TV.  David likes to watch college ball on Saturdays.  I don't care too much.  I prefer NFL but am not glued to the TV for 3 hours straight.....Just enough to see the good plays.  What is with the Bills?  Disgraceful!

Unfortunately, we had to miss Elaine's (David's sister) dinner on Saturday.  The long car ride is just too uncomfortable for me right now.  She lives in Toronto and it is an hour away.  Hope a good time was had by all!

David prepared a great turkey dinner on Sunday.  I tried supervising but was shooed out of the kitchen a lot.  Mom and Dad came over and helped David get dinner on the table.  The crazy thing..... no one snapped a picture.  With all the phones in the room with a camera!  We were hungry I guess!  



Thursday, October 7, 2010

Week of October 4th

By Monday I had decided to contact my nurse coordinator Pat to see if there was anything I could do about the muscle and joint pain.  It was excruciating and never let up.  A quick call to the hospital and the triage nurse on duty in the Cancer Centre let me know that I could take Tylenol but to take my temperature first.  It is important not to mask any fever.  She also let me know she would ensure Pat was informed and that Pat would probably call.  She did call and asked how the Tylenol worked.  It really didn't do anything for me so she let me know she would talk to the doctor and probably call in a prescription for me.

Within hours a prescription was waiting at our local Pharma Plus and I started taking a medication called Teva-Gabapentin.  It is used to relieve nerve pain and that it did by the time I went to bed that night.  Finally, a good night's rest!

Of course, every medication has its side effects and this one is no exception.  It makes me a little drowsy and fuzzy headed.  No operating heavy machinery for now.  But the pain has reduced about 80% and that is good enough for me.

Every day is a little better from the previous day.  Appetite is a little better and the fatigue is a little bit less.  I would not go so far as to say I feel normal but I think I have to come to terms about the new normal for now.

I am going out a little bit too.  On Wednesday, David and I visited Hope Springs on Allen St. in Waterloo.  Hope Springs is a not for profit cancer support centre.  They offer a variety of programs for those with cancer and their caregivers.  I got myself a lovely wig for when my hair falls out!

As you probably know chemotherapy is used to kill cancer cells throughout the body.  The chemo drugs interfere with the growth and reproduction of cancer cells.  This is good!  However, they also damage normal cells that grow rapidly such as hair follicles, stomach lining, and blood cells.  One of the side effects is lowered resistance to infection.  This effect begins 7 days after chemo treatment and reaches its lowest point from day 10 - 14.  After this the white blood count begins to improve and should reach normal levels before the next treatment.  For me the lowest point is October 10 - 14.  So if we discourage visitors don't think we don't love you!

Saturday, October 2, 2010

Day 2 & 3 after Chemo

Much of the weekend was spent on the couch.  Side effects are kicking in.  Fatigue, muscle and joint pains, etc. My head is aching but I cannot take anything.  Can't call in to my nurse coordinator because it is the weekend.  I am sure I can take some tylenol but don't want to yet.  I will persevere.

I will spare you the details regarding constipation.  My tastes buds are rebelling.  Many things just taste lousy and flavourless.  But I need to eat and make sure I have small snacks throughout the day.  Don't forget to drink lots of fluids but no booze.  Liver is already working overtime without booze.

Second day on the couch.  Mostly experiencing muscle ache and pain in my lower abdomen.  Had headache yesterday but this doesn't seem to be an issue today.  Appetite is off and every thing tastes lousy.  They warned me about this.....  mostly a metallic taste.  Even water.

First Day After Chemo

Friday, October 1st, 2010
Didn't sleep well that night but that is a side effect. Have to take my temp twice a day to check for fever (38 degrees) Must call in for instruction during business day. Or go to emergency on weekend. Yikes David bought a huge bag of masks if anyone looks like they are sniffling. Or maybe he will make me wear them....
Currently feeling a little flu ish.. slight headache that's all.. can't take anything..not that I want to. so many drugs in there right now.

First Chemotherapy Treatment

Thursday, September 30th, 2010
Oh joy...not....
Day started at hospital at 8:30. I had already taken some steroid prescription pills 12 hours and 6 hours before. Plus I had to take an anti nausea pill that morning. More nausea pills for home. They work well. No nausea yet. (fingers crossed)
Hooked me up to IV in a lazy boy type chair. I was given some pre-chemo drugs for nausea and Benadryl. Within minutes I started to feel drowsy from the huge dose of Benadryl. I also started to get ants in my pants and dancing legs. I couldn't close my eyes to doze and I felt like I had the spins from too much booze. Chemo wouldn't be started for another 30 minutes and I did not complain. I just thought ...ok this will subside....
Pharmacist came to explain my chemo drugs and talk about side effects etc. (more on this later) She went into great detail which just confused me but they are pretty accustomed to this so there is lots of paper. She said there are drugs to combat this jitteriness if I wanted. (she noticed by dancing feet) I said no. I am so tough.
Well the first chemo drug started and it takes generally 3 hours for the full dose. Within minutes my chest got heavy and I couldn't breathe. David said my face was starting to turn red. I felt a searing heat rise from my shoulders to the top of my heard. This was no hot flash. More like a f&%*ing volcano. Well thank God there are nurses all over the place (David was already running to get one) and they know this could happen to a percentage of first timers..... well one of them ran over and took the line off and gave me oxygen. Emergency call went out and within a minute they administered another steroid. The steroids help the body accept Taxol (chemo drug). Body doesn’t want it because Taxol kills cells. Obviously the pills were not enough. Now they know and adjustments will be made by the doctor. Doctor by the way (another woman) is great and explained a lot to us on Wednesday.
Anyway I had to wait another 1/2 hour to begin the Taxol and they started with small dosage working the way up to full. My mother was coming by at 11:15 to relieve David and I was so glad she didn't witness this.
All went well after this and no more funny stuff. The heebee geebees went away with the Taxol reaction. Imagine that.  I was also no longer drowsy.
Second drug (Carboplatin) was piece of cake and only took 1/2 hour. Went home at 3:00 pm and felt pretty good. Just a little tired.  Having a needle in your arm for that long is just freaky.

Symptoms and Diagnosis

This entry is intended to provide you with an account of symptoms that alerted me that something was wrong and the progression of a diagnosis by our health care system.  It is somewhat long so grab a drink.

Early August there was a day at work where I experienced a sharp pain in my lower left side.  It was quite painful and I decided to go home at noon to lie down.  Pain was mostly gone by next day and I returned to work.  Decided to call the doctor's office anyway to ask them to book an annual checkup.  I was several months overdue and this was as good a time as any.  Appointment was booked for October 14th.  Busy office.

Life went on as usual.  The only symptoms I recall is feeling bloated much of the time and my belly was expanded somewhat.  Sometime early to mid August I recall that we played a round of golf at Puslinch and we walked the course.  It was a hot day, one of many this past summer, and I recall complaining about the heat.  Nothing out of the ordinary!

Most of the time I didn't have pain per se but I was bloated and gaseous.  I made the decision I was becoming intolerant to some sort of food item and made some effort to remove wheat from my diet to see if anything changed.  I studied up food intolerances and tried substituting for wheat. This went on for a number of days but nothing changed and I was getting larger and more uncomfortable.

On August 22nd we were scheduled to participate in a golf tournament.  By now I was experiencing heaviness in the lower belly, walking was painful and looked 4 or 5 months pregnant!   Oh joy.....There was no way I could do this even with a cart and I suddenly realized I needed to go to the doctor.  Of course, it was the weekend so I went to the clinic.  After some blood work, urine analysis, x-rays and physical examination they could not give me any diagnosis.  There appeared to be some heaviness in the pelvic area and it was probably because I was constipated.  I was given a prescription for some stool softener and an appointment for an ultrasound for August 31st, which was the next step.

We spent the following 5 days at Pat and Suzanne's cottage.  It was during this time that I really came to terms with my inability to walk very far.  We would go for walks and I would end up way behind of everyone and holding my belly.  I couldn't wait to sit down again.  Back pain began as well.

The ultrasound results were available very quickly and my own doctor called August 31st to tell me that there is a sizable tumour close to my ovaries.  She was very sorry to be delivering this news via the phone but thought that I would want to know.  She had also arranged for a CT Scan and appointment was set for September 3rd.  She also arranged an appointment at London Health Sciences Hospital with Dr. Monique Bertrand, Gynecological Oncologist upon the recommendation from the Grand River Cancer Centre.  Things started to happen very fast now.  Both David and I were stunned as you can imagine and quickly had to come to terms of what this meant.

On September 7th we met with Dr. Bertrand.  In her opinion, based on the results of all the diagnostic tests and her physical examination she was quite sure it was cancer.  In the back of our minds we were still hoping it was nothing but we knew.  However, to be 100% sure she requested a biopsy with a oncologist radiologist scheduled for September 17th in London.

She described the treatment plan for ovarian cancer which would begin as soon as possible.  Good news is that I can do this in Kitchener at the Grand River Hosp.  There would be 3 treatments of chemotherapy 3 weeks apart.  Then she will do surgery to remove as much as she can.  After this 3 more treatments to get rid of the remainder missed by surgery.

She didn't think there is one mass as originally thought but several smaller ones.  All in the area of the ovaries.  There was also a possibility of cancer on the peritoneum.  This is the lining of the abdomen.  Treatment is the same for both types of cancer.

This was all confirmed with the biopsy.

Physically, I felt fine as long as I was sitting.  My belly had expanded quite a bit because of something called ascites.  This fluid will reduce with chemotherapy.  My regular clothes do not fit around the waist.


Dr. Bertrand called me at work on September 22nd to discuss the results of the biospy.  She confirmed it was grade 3 ovarian and peritoneal cancer.  Next steps was to send all test results to Grand River Hospital who would get in touch with me for a preliminary meeting.

So on September 29th we met with Dr. Califaretti, oncologist  and my nurse coordinator, Pat to discuss my diagnosis and treatment plan in more detail.  They were wonderful and caring.  Any questions we had were encouraged and they were completely accommodating.  Appointment for first treatment was set for the very next day @ 8:30 am.  My journey is only beginning.......