No soup for me!

This week's events had all the makings of a good, wholesome cancer-fighting stew.  Tuesday's oncologist appointment was very productive; after mentioning my nausea, etc from last round, we agreed I could go back on the steroid (Decadron) this cycle to keep things in check.  As it turns out, I will be going back on it for cycles 5 through 8 regardless, in order to off-set the potentially severe allergic reaction that my new chemo drug (Taxotere) may elicit.  So really, I am just starting on Decadron three weeks early.  But I am getting ahead of myself...back to round 4 and my final AC (Adriamycin & Cyclophosphamide) treatment.  

On Wednesday, while all three kids were battling their respective lingering or newly developed coughs, I remarked how timely it was that I was finally over my 7-week cough and feeling very close to 100% as I entered the new cycle.  On Thursday, after a quick jaunt to Ikea, I arrived for chemo with a belly full of Swedish meatballs, mashed potatoes and lingonberry sauce, eager for my AC digestif.  The nurse showed up in the waiting room toting my blood work results and a grim and apologetic expression.  "No soup for you!"

Ok, my nurse didn't actually say this, but that is what I heard.  My neutrophil (white blood cell) count was extremely low, 0.5 compared to the required 1.0, which meant chemo was a no go.  Neutrophils help our bodies fight infection, and as chemo destroys these cells, you need to have the required count going in to a new cycle to be allowed treatment.  Treatment would now be delayed by a week in order to give my body time to produce new cells. 

To help in this crusade, I'm told I will likely need Neulasta or Neuprogen injections.  These will boost my body's production of neutrophils.  As with the Decadron, I was going to be prescribed Neulasta as standard regimen for cycles 5-8 as neutrophils take a hard hit from Taxotere.  Unfortunately, the neutrophil booster is administered via injection - 1 injection (per cycle) if neulasta, or 4-10 injections (depending on dosage) per cycle if neuprogen.  Although needles and me are not sworn enemies, I am surely rooting for neulasta! 

I'll admit I was taken aback to hear (second-hand via my nurse) that my oncologist "is worried you won't make it through the remaining cycles without some help (from neulasta)"  Now, I realized that by "won't make it" the nurse meant "won't make it through treatment without getting an infection" (which could mean hospitalization), but it was crazy to hear this regardless.  I've been doing a lot of mental imagery, picturing the minuscule factory line going on inside there, producing and packaging up those neutrophils ready for transport to the various surveillance outposts of my organism.  It's a fancy operation, let me tell you! 

Ok, on to greener pastures!  The good news is that neulasta does exist, will help and is available to me here in Canada free of charge.  This last point is a monumental one, as these drugs in Canada run approximately $2500 a pop and I require 4 injections. In the States, I'm told the cost can run anywhere from $5000-$8000 per injection.  My heart goes out to you.  Again, I am so blessed to have such great health insurance from my employer, and I just confirmed that I qualify for the "Victory Program", a drug-company-run program that will cover the 20% not covered by my work.  I wonder if such programs and health care will be available to my kids when they are my age.  I pray they will never need them, but that they are there if they do.

Now, this little "rain delay" has wreaked havoc on our summer plans, with some positive and negative effects.  Here's a breakdown:

Advantages of chemo being postponed by a week:

I have ample energy to take the kids out for this weekend's Canada Day celebrations!
When I watch the Euro Cup final on Sunday, I can drink beer!
The delay has offset my entire treatment schedule, meaning that I no longer have a round of chemo during our August cottage week!

Disadvantages of chemo being postponed by a week:

With my increased risk of infection, I should avoid big crowds, such as those seen on, um...Canada Day.
I can't just "blame the chemo" for my insanity streak following Portugal's loss to Spain.
The delay has offset my entire treatment schedule, meaning that (1) our big camping trip (2) my brother and sister-in-law's visit and (3) Salvador's birthday party all now fall directly following a treatment.

But you know what?  None of the above matters.  My chemo is my number one priority and anything else I can squeeze in this summer is just a bonus (of course, my plan is to reschedule the camping trip and birthday party, I mean, come on, honestly!).  Bro & sister-in-law will unfortunately have to humour me & my chemo brain.  

Blessings Report
I qualified for the Victory Program. Goalo!
I not only have a fabulous pen pal (who shares the same oncologist and surgeon), but I got to meet her in person.
My number one team (Portugal) lost to my number two team (Spain)...and I can live with that.
Salvador finished Junior Kindergarten!  And, thanks to being on maternity leave, I got to accompany him to and from school. 
and finally, <insert trumpeteers>:
A dear dear friend masterfully and triumphantly brought her beautiful baby Lara in to the world. 

Who has time for lamentation when you have all of this going on?  Sure, no soup for me this week, but that's ok, it's too hot for soup anyway :^)

Ellen