6/19/12 Follow Up Appointment with my Oncologist

At this point, I feel like I have barely started to recover from the most awful chemotherapy I have experienced yet.  I had so many issues along the way but somehow I made it.  It just took a little speaking up on my part and not feeling like I had to tough out so many situations.  My veins were no longer making an appearance and the nurses and phlebotomists were having a hard time finding them and now I have a confirmed appointment with Interventional Radiology on Jun 27th to have my port placed.  You have no idea how excited I am for this.  While I have a nasty habit of watching YouTube videos on these procedures, I have not yet watched one on the port so I haven't scared myself silly yet.  Having a port means that all my blood draws for pre chemo blood work will be done through here and also my infusions will be coming through my port.  It will be placed in my chest.  To give you an idea of what we're talking about, here is an illustration of the port.

It will fit nicely under my skin and I'll be able to shower and swim like an average person.  Everyone that I have talked to about their port loves it and has nothing bad to say about it and this puts my mind at ease.  The only other needle sticks that I'll be getting is my Lovenox shots which are self injected around my navel but that isn't a big deal.  

Ready to see my oncologist!

My sister came with me to my follow up appointment and we arrived at Kaiser South San Francisco just as they were closing up the weekly Farmer's Market that they host there on Tuesdays.  We were able to grab a bag of delicious kettle corn and I went inside to check in.  Since I was seeing my oncologist today, the visit was a $20 copay.  I got called back and the medical assistant took my weight and vitals.  I had lost about 4 lbs since the last time they weighed me which really isn't all that bad considering how much fluid I carry in my belly.  I wait in the room for my doctor to come in and she arrives with a smile. We shake hands and she asks me how I've been doing.  I tell her about how chemo #5 was really hard on me and how we hit some bumps in the road but that I was finally feeling great and I was ready for another round.  We go over the procedural questions we always go through.  Any mouth sores? Tingling in fingers or toes?  Any shortness of breath?  The list is on and on and I typically don't have any symptoms or side effects.  Earlier that morning, I had gone to the lab at Kaiser in San Mateo to do my pre chemo blood work.  I had been getting the results of these tests and while I was checking them out to see if they were coming back within normal range, I wasn't trying to get myself worked up over them.  One of the tests that I look out for is my Neutrophils.  This basically tells me if my immune system is low and whether we can proceed with chemo or not.  I saw that the number was low and I was discouraged at the thought that I would not be able to do chemo the next day.  In the past when I was neutropenic, my oncologist would reduce dosage on the chemo and let me take a week break for my body to recover. I asked my doctor about this. She said that while my immune system was low, she did not want to risk taking a break from chemo as we already knew that my cancer is feisty and would probably grow.  I need to have chemo in my body consistently.  She explained to me that we would go ahead with chemo for the next day with the same dosage as last only this time, I would be getting a Neulasta shot on Thursday to help boost my white blood cells.  When I had my CT scan done on June 4th, I hadn't asked my doctor what she meant when she told me that my cancer had grown. I guess in the moment of things I was just angry and I didn't think I could handle what that meant.  But today I wanted to know.  I asked her how much my pelvic tumor had grown and she told me it went from 22 cm at diagnosis, to 14 cm after 3 cycles of chemotherapy, and now up to 20 cm after taking that 2 week break from chemo.  Now I knew what I was working with.  I was a bit devastated to know that my mass had grown 6 cm in such a short amount of time but I was also very ready to fight this even harder now. I asked what the game plan was in terms of my next PET scan and she told me that we would do one after chemo #8.  She also told me that the results of the fluid collected from my thoracentesis came back normal.  Well, as normal as can be.  The fluid is caused by my stomach cancer and there is NO cancer in my lungs.  I was very relieved to learn about this.  I didn't know if I could take another bump in the road.  We refilled my prescriptions and I headed down to the pharmacy to pick up my medications.  I had 7 of them to pick up.  I was absolutely stunned to see the retail cost of my medications.  Luckily my copay was only $100 for all my meds and with the office visit, spending $120 was a blessing to me. It just amazes me what prescriptions cost here in the US.