Hit Me With Your Best Shot: Round Three

It is the morning after my third session of chemo and I am feeling pretty lucky that my body allowed me to sleep for a decent amount of time last night.  Middle of the night insomnia seems to be one of the side effects that plagues me after my treatment sessions, in addition to massive bloating, odd tingling sensations, and general fatigue.  So here I sit writing this blog, my poor, bleeding, puppy and I curled up on the couch together, reflecting on the changes going through our bodies at this time.  Young Kublai is becoming a woman and seems baffled and confused by her brother, Chingy´s, desire to sniff and mount her at all times.  Luckily Chingy has already been neutered, and now it seems like it will be Kublai´s time in the very near future.  Don´t worry, Kublai, all will be well soon: hopefully you won´t be the other doggies favorite new meat in the park for long…

My body, on the other hand, is wondering what to do with all of the medicine (poison?) that was injected over the last two days.  The general procedure goes as follows.  First I go to the clinic in the early morning to get my white and red blood cells counted and checked.  This is an entirely harmless procedure ( if you don´t mind needles) and, so far, the blood examinations have always been followed up by a consultation with Dr. Majlis where he cheerily proclaims my blood count to be, ¨Great…Excellent!”.  Then he sits me on the table and tests my lungs, heart, glands, and examines my mouth for ulcers.  When all of these examinations go well, he then leads me back to the desk where he often makes a reference to the restaurants he likes in Houston… most often he speaks of margaritas at Pappasito´s, so I know he is a man after my own heart.  I believe this friendly banter to be an attempt at more meaningful doctor-patient communication, and also a reminder to me that he regularly attends conferences at MD Anderson.  It is as if he is subtly trying to say, “Not to worry, young gringa.  You are in good hands.¨  And luckily, I do believe that I am getting the best care possible.  In general, I am starting to like Majlis more, although Dr. “Blue Eyes” Buhler will always, hands-down, be my favorite, as I´m sure he has been for most of his female patients in the past:-)  I appreciate that even though he is more comfortable speaking to me in Spanish, Majlis always makes a gesture to converse with Jon in English and help to include him, somewhat clumsily, in the medical loop.  I also appreciate his zany sense of humor, when he proclaims “You are healthy and ready to go to the bar,” and sends me on my way to my hospital room.  I like that he tells me, in response to my query about dietary restrictions,  “No restrictions!  Eat steak, drink wine: as long as you are feeling good, live your life.”  How very Chilean of him…  I´m sure many of my alternative medicine friends would not agree with this prognosis, and believe me, I know that many people would cringe to hear that I, the cancer patient, still cook delicious meals filled with animal protein and occasionally indulge in a glass of libations (don´t worry- not nearly as much as in the past…).  But to restrict me in those ways is not to know the real Eli, and is not to fully appreciate the joy and pleasure that food brings me.  I like that my doctors understand that a life without joy is not worth living at all.  At this time I am reminded of one of my favorite kitchen ceramic hangings of all time, found in a friend´s beach house in Alicante, Spain that proclaimed, ¨A Day without wine is like a day without sunshine”.  Truer words have never been spoken!

But, alternative medicine friends, don´t fret too much- my body is a very good indicator of what I should or should not be putting in my mouth.  Always after the first week of treatments my taste buds change dramatically.  The chemo attacks the fastest growing cells in the body which include hair, nail, and mouth cells, so I tend to lose a layer or two of skin on the tongue and roof of my mouth following the sessions.  Wine and other flavorful foods like red meat, cheeses, spices or heavily salted, buttered, or sugary items just do not taste good, as all my senses pick up on are the metallic flavors, the alcohol, the heat, or other such sensations.  Luckily, after a week of gargling with sodium bicarbonate following each teeth-brushing ritual, my palette generally tends to recover midway through the second week, and I again become free to savor the fruity nose and vanilla notes of the Malbec once again.  So until my test results tell me otherwise, I will not be subsisting on a vegan diet, attending any hypnotherapy sessions, or visiting any shamans on the outskirts of Patagonia, as many have suggested.  I do appreciate your interests and concerns about my treatment and I have looked into many of them, but I just do not feel this is the right path for me at this time.  Sorry, Dr. Stroud and Dr. Caughron: I know you must be quite disappointed in my choice… but cést la vie.

Okay, back to my treatment regimens….  Once at the hospital, I check in to my spacious room with views of the mountains and Vitacura Avenue, usually early Friday afternoon.  Inside, in addition to my hospital bed, there is a small table and chair set, a pull-out couch that my mother so lovingly agrees to sleep on, and plenty of room for the two of us and Jon to lounge around and while the time away.  Jon always brings plenty of homemade sandwiches, People magazines, speakers, WII games, TV cords, and enough I-gadgets to make Steve Jobs applaud us from the grave.  With all of those accoutrements, it truly does feel like home.  Well… at least we are never want for entertainment, that is for sure.  Which is good, because hospital stays in Chile always seem to last at least 8 hours longer than they need to… I truly dislike when the nurse comes in Saturday morning to tell me I only have one drug to go and that I´ll be out of there by noon, when, in fact, I know that they won´t even start giving me my pre-chemo, anti nausea meds until at least 2:00.  I don´t mind waiting, I just dislike false attempts to get my hopes up.  I would prefer it if the nurses would stick to critizing Jessica Biel´s pink wedding dress or Jessica Simpson´s pregnancy weight gain, when they excitedly pick up my glossy magazines off the bed.  I also appreciate conversing in Spanish as they marvel appropriately at the crazy culinary confections emblazoned on the television screen during my marathon sessions of “Kitchen Nightmares”, “Top Chef”, “Cake Boss”, and “Man vs. Food”.  It always interests and amazes me to see how pervasive American culture and entertainment has become throughout the world.  I find it kind of sickening (yet entirely comforting) that even in Dalian, China I could always count on a Saturday Starbucks coffee run, a six inch BMT on Parmesan Oregano bread at Subway, or an Oreo Blizzard at the Dairy Queen stand in Ansheng Mall.  All this talk of food is making me hungry!  And also reminds me that my brain, on chemo, tends to wander.  Sorry for the rant about American culture.  Now back to the original topic at hand… my treatment.

This last round of chemo was made more difficult and emotional, however, by the departure of my father and sister late Thursday night.  We had such a good time together and it was hard to say goodbye.  Don´t worry- a blog regarding the Timms family adventures will be forthcoming:-)  Perhaps my sadness led to a heightened sense of anxiety about the treatment this time.  Or perhaps I was just tired after traipsing the hills of Valparaiso the previous two days.  (I did have quite a bit of back pain following my physical exertions, but it was worth it.)  I think, mainly, though, my apprehension stemmed from the fact that I absolutely hate going to the hospital.  I don´t like being reminded of my sickness and I especially despise feeling weak and vulnerable, smelling like medicine, and being helped to the bathroom with my IV drip.  These are not the images of strength that I want to remember from this journey.  I would prefer to remember a festive Friday night sitting in a small restaurant with my sister in Bellavista, sipping sangria and watching some dramatic flamenco dancing.  I would rather remember my mom getting pulled to the park on her walks with Chingy, both of us laughing so hard, it was difficult to regain our composure or control of the leash.  I would also rather focus on the image of my dad wolfing down every last bite of the chocolate brownie with homemade ice cream at Pasta e Vino, as though he hadn´t eaten in days.  (That brownie was supposed to be shared between the four of us, Dad:-)  I digress… the point is, that less than two months ago I never would have envisioned spending my Friday night hooked up to bags of life-saving medicine.  My weekends used to be filled with more fun and colorful cocktails, followed by plenty of dancing.

Speaking of cocktails, I finally remembered to write down the names of the actual drugs that are being administered during my Friday night/Saturday morning drug sessions for those who might be interested.  Please, however, do not take this as an opportunity to criticize my treatment plan or send me web links with survival statistics related to these drugs.  I fully trust what the doctors at Clinica Alemana (in conjunction with their colleagues at MD Anderson) have decided to go with.  On Friday nights I take two monoclonal antibodies designed to “interfere with the Her2 neuron receptor” (I am committing the cardinal sin of citing from Wikipedia… shhhh… don´t tell my students!)  One of the drugs is called Herceptin, which has been around for awhile, and the new drug, Perjeta, which was approved by the FDA in June.  You can read about this drug here: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm307549.htm     As many of you know, I am not really scientifically inclined.  I distinctly recall a conference with my chemistry teacher, Mr. Battaglia, after my bout with mono junior year where he told me not to worry about making up the tests, because, “Let´s face it, Ms. Timms, you are not going to be entering a career in the science field.”  Hey, it´s not my fault that I could never light a Bunsen burner correctly, or that my macaroni bridge fell down even BEFORE Mr. Godwin put the weights on it…  Luckily CMC offered some wonderfully designed college courses like forensic science, and astronomy to help my fulfill my science credits.  The long and short of this admission of my academic weakness, is to ask forgiveness if I don´t explain this next part so well… I gleaned most of my understanding of the drugs and my treatment from a drawing of my cells that my doctor made for me after a few minutes of quizzical looks and blank stares.  Apparently, my type of breast cancer is a hormone based cancer (HER 2 positive) and each of the cancer cells has some sort of indicator on them that designate it as this type of cell.  The antibodies attach to these cells and prevent them from growing and spreading.  In addition,  I am also undergoing traditional chemotherapy (taxotere) to reduce and hopefully eliminate the cancer cells in the other parts of my body, specifically in the vital organs such as lungs and liver.  The chemo sessions will eventually stop, but the antibodies will continue indefinitely, until a newer and better cure can be found.

The traditional chemotherapy drug is given to me on Saturdays and is the one I dislike the most.  My body definitely does not like taxotere.  Before this horrible toxin is pumped into my blood stream via catheter, the nurses fill me with bags of saline, at least three different anti nausea medicines, an antihistamine to prevent allergic reactions, and some anti-coagulants to prevent clotting around my catheter and heart.  Also, they give me some sort of drug to make me sleepy and relaxed so that I don´t notice the drug as much.  Good luck with that one!!  Last time, you may remember, I had a reaction to the taxotere which involved me passing out briefly with my eyes rolled back into my head.  I was very worried about this unpleasantness happening again, so attempted to concentrate on my TV show instead.  Unfortunately when the same metallic flavor began filling my mouth and my vision became blurred and my breathing labored, I immediately knew what was wrong.  I paged the nurse, who though I was just having a panic attack??!!, and she calmed me down, closed my blinds, and turned off the lights so that I would be in a zen environment for the two hour ordeal.  Luckily, this time, I managed to calm myself before I passed out, and was left only with white and black spots in my vision.  Ugh, have I mentioned that I hate chemotherapy…  But as Jon lovingly reminded me, I am in need of something strong to get rid of the evil in my body, so I guess I will just focus on the cure.

That´s it for now… my many thanks go out to “Team Eli” members around the world who are following along and sending me well wishes.  I am including a picture of my family in our pink “Team Eli” t-shirts, which has already proved quite popular on Facebook.  I´m sure you will be hearing from me more regularly now, since my mom will be returning home early Tuesday morning, and I will have lots of solitary time to think and reflect.