Serving Up the Second Course

As I'm writing this post, Lynne is laying in bed snowed under from the Benedryl she received with her 4th chemo treatment. I wasn't planning on writing this post but as I'm sitting in front of the TV tonight with her phone beside me, I'm a bit overwhelmed by the number of text messages that she receives from family, neighbors, friends, co-workers, parents of our kids' classmates, teachers and everyone else that's rallied around her to provide support and just to check in. We really have an amazing support system around us and I can't thank everyone enough. Your outreach inspired me to put down my beer, get off my duff and write this post to provide everyone an update.

The morning starting off with lots of nerves. Lynne was hopeful that, after last week, her treatment team had dialed in on the right pre-treatment dosages. At the same time her reaction to the Herceptin from the first week was definitely lingering in the back of her mind.

We arrived at MGH West a little before 9AM for her lab and since this was the first day of her second course of chemotherapy, we met with her medical oncologist, Dr. Comander. A number of positive things came out of this meeting. First, when Lynne told her  doctor that she's been unable to locate her lump since after her second treatment, Dr. Comander confirmed that both her tumor and swollen lymph node were no longer detectable through a manual exam. Dr. Comander was pleasantly surprised and told us that the majority of her patients don't show this type of progress until after the start of their second course of chemo. The second, more humorous, discovery was that Lynne has been applying the wrong medication to her port before each chemo treatment. Dr. Comander had prescribed both a hydrocortizone cream for a rash that Lynne had developed as well as topical anesthetic to help numb the pain of the needle insertion into her port. On a positive note, we're hopeful that subsequent needle insertions will be less painful with the application of the correct medicine! The third, more anecdotal thing, that we learned was one of Dr. Comander's colleagues has a theory that most patients who have a Herceptin reaction are having a tumor reaction to the medication. Her theory is that the reaction is a good sign that the Herceptin is affecting the tumor. We can now add Lynne as an additional data point to support her colleague's hypothesis. The fourth thing we learned was that it's very rare for patients to have a second reaction to the Hercpetin. Lastly, we came to the realization that when you've surrendered to having to spend the entire day at a hospital you're not at all impatient about the doctor being late for your appointment! Not a bad start by my standards!

I'm happy to report that today's chemo treatment went as well as any chemo treatment can go. For starters, nurse Anne (from her first treatment) was assigned to her care. Anne is not only compassionate and kind but is very knowledgeable about the treatment and protocols of Lynne's treatment. The treatment team did up her dosage of Benedryl over what was administered last week though as the start of every course of chemo involves three infusions. Since she had a reaction to the Herceptin during her first week, her treatment team decided they would split the difference in dosage for the Benedryl just to be safe and landed on 37.5mL dripped through the IV over 30 minutes. Since she didn't have a reaction to the Herceptin  this week, she'll be receiving 25mL during her Taxol only treatments and 37.5mL at the start of each course.

Her port was flushed and disconnected at about 3:30 and we were in the car around 3:45 today. That included a 30 minute monitoring period after her Hereptin infusion, before the Taxol. We're hopeful that the remaining two courses will start just as well!

One other funny thing that came out of the day today was I told Dr. Comander about something Katherine said during dramatic play with Carter. While they were playing one day I overheard her say to Carter "you have no hair, that means you have cancer". Now, we were warned by the director at her center that this might come out during dramatic play but it still caught me by surprise since it was the first time I ever heard Katherine even talk about the cancer. Dr. Comander thought it was cute and shared with us that one of her patients is a piano teacher. One day her patient observed 4 of her students sitting on a piano bench completely still and quiet. When she asked the students what they were doing, they said they were waiting in a hospital waiting room. I'm glad to see Dr. Comander can joke about her own profession.