Treatment Plan & Chemo Round 1

My oncologist (Dr. H) has me on an aggressive treatment. Most with colon cancer are treated with either FOLFOX or FOLFIRI. I'm getting FOLFOXIRI. Three different chemo drugs (Oxaliplatin, Irinotecan, and 5 FU) at +20% the normal dosage. 12 rounds. 6 hour infusion, and a take home chemo bag that infuses 5-FU over 46 hours. It's a harsh treatment, but attitude is EVERYTHING!

We went over side effects:  nausea, diarrhea, anorexia/loss of appetite, metal mouth, and hair thinning in later rounds. The diarrhea thing was the most emphasized side effect, and this is where I learned to be thankful for my tummy gremlin (stoma). Some people on chemo end up wearing diapers or having to apply a little butt paste. Thankfully that wouldn't be my experience. 

Round 1:  I wasn't expecting it to be hard. Everything I've read and experienced with my dad told me the first round was the easiest. Chemo compounds and gets harder over time. 

With about two hours to go the neuropathy started affecting my speech, and then the nausea hit. My tongue was half numb, so my speech was slurred. I refer to it as being chemo drunk. I was so nauseous I needed a wheelchair to get to the car. By that evening the neuropathy & nausea subsided, and I thought I was home free. 

Nope. The infusion was Tuesday, and by Saturday the nausea returned. I had Zofram and Ativan to help with nausea. Zofram is hit or miss. Ativan knocks me out. The more I moved the worse it got. Fred ran out and got ginger gum, Dramamine, and an essential oil based product to rub behind my ears. Anything he found for nausea, he bought!

I had a newborn photo shoot scheduled, and I had to leave the shoot early. I was struggling with fatigue, a hormonal hot flash on top of chemo hot flash, and nausea every time I moved. It was awful. I hate failure. I promised to return the following weekend. 

By Sunday I was weak & dehydrated. I waited until Dr. H's office opened to go in an get some fluids. I was feeling pretty terrible, and Dr. H decided to admit me for a "tune-up". He explained early on to expect 24-hour tune-ups. He'd rather me go into the hospital for a day vs. trying to tough it out and be admitted for a week. 

Once we got the nausea under control and I was able get some food down, I was ready to be released. I had gone in just before my blood levels started to drop, so the upside was now I had an idea of when I needed a "tune-up" before my levels got out of control. 

I continued through the rest of the week struggling to eat. Loss of appetite is such a strange feeling. Your body is hungry but nothing is appealing. Nothing. And sometimes trying to force food brings on nausea. I downed a protein shake so I had enough energy to get through the make-up photo shoot. (I'm truly grateful that family was so incredibly understanding.)

My appetite returned the day before Round 2 was scheduled. Needless to say Round 2 was delayed a week. But the upside is I had Biopsy #2 scheduled, and based on the first biopsy I needed time to recover without chemo. In all honesty I wanted to push through, but Dr. H's saying is slow and steady wins the race. 

CT MRI Biopsy, Oh My!

Five weeks after surgery I was finally healed enough to lay flat for thirty minutes, and able to get a new MRI. The previous MRI showed a possible spot on the liver, but it wasn't a good scan because it was post-surgery. This was a big one. The one that would confirm stage III or IV. 

•I have a tiny 1.5 cm lesion on the liver.

•I'm officially diagnosed as stage IV.

A biopsy followed to confirm colon cancer. 

Enter the most painful thing I've experienced to date. Biopsy #1. Going in I knew there was a 50/50 chance it would be painful, and because of the location they didn't allow much sedation. I felt the crunch as the needle passed through my tissues. I was crying on the table. Crying! I am not a crier. I breathe or moan through pain. When I cry, it's bad. And the pain didn't go away after the procedure. Two rounds of morphine did nothing. Dilaudid finally got the pain under control. And then I spent the next five days drugged, attached to a heating pad. 

When you label something #1, there has to be a #2. Yep. All that pain and it wasn't a good sample. Just the thought of having go through that all over again had me in tears. But the second would be done at Emory, and I made them well aware of the pain I experienced during the first biopsy. The first was CT guided, but the Emory biopsy team came in and based on the location they wanted to do MRI guided. It meant I would have to reschedule, but if there was even a slight chance it would make the procedure less painful I jumped!

By the time the MRI assisted biopsy was scheduled, I had completed my first round of chemo. This time I was under twilight sedation. You can listen and complete tasks, but typically don't remember. Oh, I remember. I let out a good moan as the needle pushed through, the doctor was surprised that I was awoken by the pain and quickly increased the sedation meds. I was given a script for Percocet to manage any post procedure pain (I wasn't prescribed anything after the first biopsy). The team at Emory did a fantastic job, and I only had minor pain. Hallelujah! 

If your lesion is high, on the "top" of the liver, ask for a MRI guided biopsy. Seriously. No one needs to experience the level of pain I went through with the CT guided biopsy.