I am SO happy to report that on Monday, I received my LAST chemo infusion!

Cue the confetti!!!

I got to ring the bell, and afterward, we went to Cheddar’s Scratch Kitchen and celebrated with cheese fries and a giant slab of chocolate cake (over half of which we totally brought home, even with two of us eating on it. That slice was enormous!)

Of course, “finished” is a relative term when it comes to this sort of thing in a breast cancer journey, I’m learning. Depending on my surgery date, I may in fact need one more abbreviated round (only one chemo drug, and not the one that makes people sick) just to make sure everything stays shrunken before surgery. They have that on the calendar for Oct 7, but as of when I’m writing this, I don’t actually have my surgery date; it could be Oct 4, in which case this round would be cancelled.

So what’s coming next? Well, as I just mentioned, surgery is next up on the docket in early October. A lumpectomy is off the table for me due to the size of the tumor versus my size…it doesn’t leave me enough breast tissue. So mastectomy was a definite, and the choice I had to make was single or double. Due to my young age and the fact that I’ve already proven myself prone to breast cancer despite negative genetic testing, my chances of getting breast cancer in the other breast at some point in the future is quite high. If, however, I have it removed now, that chance drops by 90%. I am not interested in going through this again if I can help it, so I’ve opted for the double mastectomy, which is what they recommend for someone my age.

The next decision to be made then was what to do for reconstruction. The choices are between silicone and free tissue, which is when they basically give you a tummy tuck and use that tissue and skin to rebuild the breast. In some ways that’s the best option, but as my team put it, the chances of the skin being damaged in radiation is high, and if we’ve already used that skin from my stomach, there’s nothing to fix it with. If however, the skin is damaged and we’ve done silicone, we can still use that tummy/thigh skin to fix it. So they recommended starting with silicone and having the free tissue as a backup, which is what I was leaning toward as well and what I’ve decided on after much thought and prayer.

I still need to decide, then, where I want to do radiation, which will begin around 4 weeks post-surgery. I definitely did not want to do my chemo and main treatments in my hometown, but my oncologist on Monday said he wouldn’t hesitate to go to Cumberland for radiation–the treatments are standardized, and he knows and trusts the radiation oncologists there. He said he wouldn’t have recommended general oncology there–they don’t specialize, which means the same doctors are working with all kinds of cancer, and they have twice as many patients each as they do in Morgantown. As he put it, when you’re dealing with that many patients with that many cancers, there’s just no way to keep up with the details of each one. By focusing solely on breast cancer, my team in Morgantown can stay on top of all the developments in treatment, and they’ve found that making very small adjustments can make a big difference. As he explained it to me, radiation is very different. The plans are standardized, and they would come up with said plan in Morgantown and then Cumberland could just carry it out, and there’s little room for user error. And since it’s 5 days a week for a month, saving myself 3 hours of driving a day has definite benefits! I’ll continue to pray about it, for sure.

And even after radiation, I won’t be done. I will still have 11-14 more infusions of anti-HER2-protein meds, given every three weeks, back in Morgantown. Sometimes these can start during radiation, sometimes the radiation oncologist will advise waiting until radiation is complete. Sometimes they may involve the same chemo that I may get before surgery for 3 rounds or so, if they weren’t totally confident that all cancer had been obliterated by surgery, but if we see complete response beforehand, it won’t be necessary to tack that one on. Either way, I should be through the worst of the sickness here in the next few weeks, and the other side effects should start going away by surgery. Hair and nails should begin regrowing/repairing soon.

Have I mentioned the fingernail stuff? Before my 5th infusion, I began noticing my nail beds going wonky and pulling away from the nails, on some fingers more than others. I hadn’t been aware that this could happen to have looked up how to prevent it beforehand, but my oncologists, when I brought it up, did say that it’s pretty common and that I could lose some nails. They’re hanging on so far, and hopefully I won’t fully lose any at this point. I bought something called PolyBalm, which was developed in the UK–it’s a waxy/herbal product you apply directly to your nails twice a day. Their studies showed that of the people who used it the whole time during chemo, none experienced nail problems. The control group, however, did. Results are mixed when you start it after seeing issues, though plenty of patients had before and after shots showing it helped restore their nails. I got some, figuring it was worth a shot. I haven’t noticed them getting any worse since I started using it, so that’s a plus. And now I know what I’m going to send people when I hear they’ve been diagnosed with cancer!

I also met with PT on Infusion 5 day, and I’ve been doing exercises they gave me for leading-up-to-surgery. Because I have lymph node involvement and they will have to remove the nodes on my right side armpit, that means I’m at risk for lymphodema. The lymph nodes are the body’s drainage system, and removing them means fluids could stop draining properly in my arm. The exercises, and others I’ll be given for after surgery, are meant to help with that. I was also instructed to wear a ring on my right hand and pay attention to which notch my watch is buckled on–one of the first signs of lymphodema is swelling in the wrist and hand, and the ring and watch will help me know right away if that’s happening. If we catch it early, they can usually stop it without lasting effects; if you don’t catch it early, you can end up with mobility problems in your arm for the rest of your life. Not interested in that, thank you! So I will be paying close attention and doing my exercises religiously!

So as we can see here, chemo is done, but there is still quite a long road ahead of me; those anti-protein infusions will take up to 42 weeks to complete, which means I’ll have been in this whole process for more than a year before I’m officially “done.” Which in some ways is crazy to think about. When my sister had non-Hodgkins Lymphoma 8 years ago, it was serious. It was a dangerous cancer with incredibly intense chemo treatments–her infusions lasted a week each! She had to cart it around with her! But after her six rounds of super-chemo, she was done. No surgery, no radiation, no follow-up infusions. It’s funny to think that mine is the “easy” cancer by contrast, yet so much more involved and drawn out in the treatment process. Not that they can really even be compared, of course, but being most familiar with her treatment, I was quite surprised at how long mine would be.

But so, so happy to be finished this part of it! The rest shouldn’t make me sick, and I am SO ready to move out of the stage of constant nausea. Even though I haven’t had vomiting or diarrhea much since round 3, I have not had a single day since treatments began in May that I haven’t felt nauseous at some point in the day, even if it’s not all day. Three+ months of a rolling stomach is exhausting, and I am so ready to be out of this stage! I’m looking forward to celebrating the end of it with my writing retreat in Kansas City in September, and then going to my 20th reunion at our college Homecoming the last weekend in September. Those are two things that will be such fun before I move to surgery and recovery and then on to radiation! And of course, we have our December vacation to look forward to after surgery and radiation. Very excited for that!

My overall energy levels are already improving too, though these last few weeks my legs have felt so tight and tired whenever I walk. My labs on Monday showed my protein and iron levels were a little low, so maybe that has something to do with it. Clearly I need a nice steak. 😉 But at any rate, I’m already so much better than I was, and I am so looking forward to reclaiming health and getting my body back in shape! (Eating helps with the nausea, which means I’ve been gaining instead of losing weight, which is not what I wanted to happen! But I figured “Get through this first. Worry with that ten pounds later.”)

So here we are! DONE with the nastiest bits and ready to move on!! Thank you all SO MUCH for traveling this journey with me! Your constant influx of prayers and support have brought me countless smiles and made it so that I have never, for one minute, felt alone. I appreciate you all so much!