August 25, 2010 - Mid-Day

Much more tired today than yesterday.  Got up at 6:45 AM and made a small pot of coffee.  At 8:00 I walked the .7 mile circle once with my neighbors, Bev & Connie.  I only did one lap because toward the end my shins were feeling kind of sore.  I guess that could be from the injection yesterday, although I thought they said I'd feel it mostly in my neck, shoulders, arms and upper back.

Took a nice, luxurious hot bath, had a small breakfast, and headed to the shop.  But I've been moving very slowly here today.  Not much energy, but a lot to do.  The Treasure Trek starts tomorrow at 8:00 AM and I had to finish up the yellow signs and get my fairy garden plants out on a table.  I also put all of my breast cancer related paperwork together in one binder.  It contains all of the explanations and side effects of the treatments, support resources I've been accumulating from various sources, and my bills and EOBs as I get them.

Thank God we have health insurance through Al's work!  So far the gross charges for the biopsy and surgery alone total $18,656.63, of which our portion will be only about 5% of that, although we haven't gotten all the bills yet.  Linda, my chemo technician, was telling me that the chemo treatments, depending on their make-up, can cost from $4,000-10,000 EACH! And I'll be having eight of them!  It will be interesting to see the statements as they come.

Maybe this is a good time for a little chemo lesson.  Cancer is characterized by rapid-cell division -- out of control cell replication without any checks or balances.  This rapid cell division happens in cycles from a resting phase, through an active growing phase, and then to mitosis (division).

Chemotherapy kills cancer cells by halting cell division; if the cancer cells are unable to divide, they die.  Some chemotherapy drugs affect cells only when they are dividing, and are called cell-cycle specific.  Other drugs affect cells when they are at rest, and are called cell-cycle non-specific. The chemotherapy schedule is set based on the type of cells, rate at which they divide, and the time at which a given drug is likely to be most effective.

The two drugs I'm taking now are Adriamycin (the red Kool-Aid) and Cytoxan.  Adriamycin acts during multiple phases of the cell cycle and is considered cell-cycle specific.  Cytoxan (which is actually a derivative of mustard gas) is most active in the resting phase of the cell, so is considered cell-cycle non-specific.

Unfortunately, chemotherapy does not know the difference between cancer cells and normal cells -- it only knows that it is to kill all cells that are rapidly dividing.  There are other, normal cells in the body that also rapidly divide, such as cells in the mouth, stomach and bowel, hair follicles, and blood cells.  This is why most of the side effects of chemo drugs are mouth sores, nausea or diarrhea, hair loss and low blood counts.  Once chemo stops, these other normal cells will grow back and healthy.

The most troubling side effect is the low blood counts, particularly low white cells.  Once chemotherapy starts, the bone marrow stops producing new blood cells.  If a patient gets any infections, the white cells in reserve can get used up and no more are produced, unless chemo is stopped for a time to allow the blood cells to build up again.  This retards the effectiveness of the chemo treatment.  This is why, 24 hours after a chemo treatment is complete, a cancer patient gets an injection of Neulasta, a drug that stimulates growth of blood cells.

So ... that's the cancer treatment lesson of the day.  Now I'm going to go sit in grandma's rocker for awhile and try to get through the day.