It has been an extremely busy couple of weeks which is why I have been so quiet. The latest COVID-19 spike has kept me and the incredible Addison ladies very busy. We have been working around-the-clock to comfort and support as many of our brides and grooms as humanly possible. The mountain of work has resulted in the days evaporating and I found myself waking up on Hanukkah morning with no candles for the Menorah, and a Christmas tree standing proud, but no presents to adorn the base. I would be lying if I said this was anything but the norm annually. The frazzled dashing between packed malls and supermarkets filled with crazed shoppers sharing anything but holiday joy happens like clockwork every year for me. Every year I swear it is the last time I put myself through all the stress, and yet like clockwork, I find myself doing exactly what I said I would never do again.
This year I decided to give myself a vacation from trying to create the perfect Martha Stewart holiday magic. Rather than the normal panicked rushing-around in the pursuit of holiday season perfection, I am going to be kind to myself and do nothing but embrace this festive season for once, with some rest and relaxation - with lots of giving, and plenty of love and laughter.
I was due to start chemotherapy on Wednesday, December 9, but as I shared on my last update, some of the tissue under my right breast died; my surgeon felt it was safer for me to delay starting for another week. The medical term for this condition is necrosis and my surgeon needed to cut away this tissue to reactivate the healing process. Healing was happening, but not quickly enough for him to clear me for December 9. He did not want me to start chemotherapy until the wound site was mostly healed because the chemotherapy (which targets and kills rapidly reproducing cells) would slow the healing process down even more. He finally cleared me to start Wednesday, December 16.
I had weeks to prepare for the start of chemo, but I found myself cramming way too much into Tuesday (the day before). By day-end, I was not ready to leave work - but with the calendar was marked, I was fully committed and mentally prepared to take on round two. The Addison family was not going to let me leave without a celebration and they gathered with me for a wonderful get-together under the banyan trees. I was given yet another thoughtful package crammed-full of items you do not know you need until you are a cancer patient. They also made an enormous photo montage that documented the years of us all together. It was so meaningful; I shed a tear or two. I am blessed to share my life with these incredible people. I left the Addison just after 8 pm, apprehensive but at peace, and armed with a positive mind set to kick cancer's royal behind.
No sooner had I fallen asleep, Wednesday arrived. I started my day by going for a long walk with my fur babies, which always sets my day up for success. I arrived at Sylvester Comprehensive Cancer Center at 8 am. The first stop of my day was for my lab work. The nurse accessed my port for the first time (successfully!) and took seven vials of blood, which were immediately sent for analysis to get my baselines for a myriad of measures (like platelet count, monocytes, albumin and alkaline phosphatase). Each result is a snapshot of how my body is handling the treatment, allowing my oncologist to adjust accordingly, with the goal of trying to keep me as healthy as possible throughout this treatment plan. Once the blood was taken, my port line was taped-down and ready for my chemotherapy treatment.
Next, I went for my consultation with Dr. Vogul my oncologist. We discussed the side effects of Taxol which could include mouth sores, low blood count, hair loss, nausea, vomiting, light sensitivity, body aches, hot flashes and chills, loss of toe and fingernails, and neuropathy in the hands and feet ...to name but a few. Dr. Vogul advised me that ice therapy can help to reduce or eliminate neuropathy and nail loss. I had heard of ice caps to potentially stop the loss of hair, but the confused look on my face must have amused Dr. Vogul. He laughed and stated, “yes, it really is as bad as it sounds”. He stressed it is optional, but he would recommend it to his daughter. I made the decision to proceed with the ice therapy in the hope that I can avoid neuropathy and nail loss.
Following my consultation, I went to the CTU area (Chemotherapy and Transfusion Unit) and was delivered to my treatment room. The pharmacist was printing my medical orders from Dr. Vogul to release my treatments. All medicines are given via infusion through my chest port. They started me with Benadryl, to reduce any allergic reactions. This was followed by an infusion of Zofran for nausea and vomiting, and finally Pepcid for reflux and gastral discomfort. Thereafter, I was given saline to flush my lines. This process took about one hour. I then had my feet and hands submerged in ice for 15 minutes and then bandaged with more ice to keep them frozen throughout my chemotherapy infusion. This stops the chemotherapy from accessing the cells in the toes and fingers, and hopefully will stop the neuropathy. For the duration of my Taxol infusion (two hours), they remain in ice.
Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue. ‘Normal’ cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition. Cancerous cells lose this ability. Cancer cells no longer have the normal checks and balances in place that control and limit cell division. The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division. Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division. If the cells are unable to divide, they die. The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells. Chemotherapy is most effective at killing cells that are rapidly dividing. Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells. The normal cells will grow back and be healthy but, in the meantime, side effects occur. The normal cells most affected by chemotherapy are the blood cells, the cells in the mouth, stomach, bowel, and the hair follicles - hence the side effects detailed above.
Interestingly, Taxol belongs to a class of chemotherapy drugs called plant alkaloids. Plant alkaloids are made from plants. The taxanes are made from the bark of the Pacific Yew tree. The plant alkaloids are cell cycle specific. This means they attack the cells during various phases of division. Antimicrotubule agents (such as Taxol), inhibit the microtubule structures within the cell. Microtubules are part of the cells apparatus for dividing and replicating itself. Inhibition of these structures ultimately results in cell death.
So now that we know what is going to happen, the pharmacist had me sign my treatment consent form and they delivered my Taxol to me to be infused over the two hours, with only ice for comfort. I did not experience any discomfort or pain, other than freezing hands and feet. Once my nurse completed flushing the port with saline, and administering Heparin (which minimizes the risk of blood gathering on the catheter and causing clots), treatment 1 of 17 was complete. Following an exhausting seven-hour day, I headed home to rest.
The symptoms I have had since returning home are relatively mild. I have experienced some host flashes, chills, bone aches, headache, and nausea, which I am trying to manage with peppermint oil. I plan to return to work Friday, after a day of complete rest, and post this update.
Every cancer patient has their own unique journey. I am a fiercely private person, but my cancer diagnosis has pushed me to want to raise awareness and funds in the pursuit of prevention and cures. The only way I can achieve this is by sharing my personal journey. By doing so, hopefully some good will come of this unexpected twist in my life. As I shared recently, I am one of the ambassadors for ResearcHERS: Women Fighting Cancer. It is an initiative created by American Cancer Society dedicated to funding women-led cancer research.
I am excited to share that I have two fundraising efforts coming up. As it is the season for giving, I ask that you get involved in some way.
First, we are selling Bodvár- House of Rosés gift boxes! This brand not only produces delicious, high-quality French wine, they are wonderful supporters of breast cancer research and have generously offered to donate the proceeds to our ResearcHERS campaign. Purchase yours here: https://www.thepinkfightclub.com/shop
The second is deeply personal. I will start losing my hair quickly; so I have decided to shave my head publicly, and not in the privacy of my own home. My care team advised me hair loss almost always happens 2-3 weeks in. Being an organizer, and particularly controlling, I do not want to relinquish control to cancer by allowing it to take my hair on its timeline. Additionally I want strong healthy hair to donate to Locks of Love, which is why I have decided to take the loss of my hair into my own hands, at a time I choose. I have set aside two hours on Tuesday, December 29 at 4 pm, via a live stream (with my mum by my side), and together we will shave our heads. Details for this event will be posted shortly on thepinkfightclub.com.
For my British family and friends, grab a wine, stay up later than normal, and tune-in to be part of the experience. There is only one place on earth I could do this and be at peace.
Every day for 13 years, I have walked through the gates of the magnificent Addison, and the Banyan trees immediately envelope me with joy. Their strength and sheer magnitude are not only magnificent, but healing, and symbolize so much to me. I want to be under them when I take the leap into baldness. Any donations will benefit the American Cancer Society, and I ask you to donate in my honor to my ResearcHERS page. It will help fund global cures that will benefit the future generation of women worldwide who will suffer the trauma of cancer.