28 July 2023
I was supposed to have two doctors’ appointments today but Dr. Burgers rescheduled for Monday. Instead, I met with Dr. Velez’ nurse, Danielle, and then later with Dr. Velez.
Danielle pretty much answered all my questions and by the time Dr. Velez came in, I had to come up with some new ones.
I cleared up the 9 weeks question I had. Even Danielle had it wrong. Dr. Velez follows the Dana-Farber protocol of using Herceptin and Taxol but he decided to modify the protocol, particularly for me since I’ve already had one chemotherapy that included Herceptin when I did the four drug regimen.
In essence, I’ll start chemo on August 21 at 9:30 am and will have it every Monday for 9 weeks. I will get 80 mg/l of Taxol for each of those Mondays. I also thought I would be getting Herceptin at the same rate but Dr. Velez will put me on the every-three-weeks regimen immediately for Herceptin so there will be only three times during the nine weeks that I get the Herceptin.
After the nine weeks, I’ll continue Herceptin alone, every three weeks for one year (or 14 sessions). Once my year of Herceptin is up, I’ll be on Tamoxifen for 10 years. The 10 years is based on research with people with the same genetic markers I have for my cancer.
Every infusion date, they will test my blood and pay particular attention to my white blood cell (WBC) count. If all normal, I will not need the next day injection to boost my immune system required with the old protocol. Apparently the two drugs they will give me during each infusion doesn’t destroy the bone marrow like the four drug regimen did.
Because Herceptin has effects on the heart, every two or three weeks I will undergo an echocardiogram – for a year.
Taxol, of course, has side effects. One is bone pain. They will preemptively work on that by administering Decodron before each treatment. It’s for arthritis (yes) allergenic reactions (yes) blood/hormone disorders (no) skin diseases (maybe) eye problems (no) breathing problems (no) bowel disorders (boy howdy!) cancer (yes) and immune diseases (no). Another issue with Taxol is peripheral neuropathy but unless it gets severe, and they don’t anticipate it to do so, they’ll stay the course on the dosage. Otherwise, they’ll cut back on the dose.
Taxol does cause diarrhea but Dr. Velez feels confident my low dosage for 9 weeks will allow me to skip that problem.
So, in summary, I’ll get 16 doses of Herceptin (one dose every three weeks) and 9 straight weeks of Taxol. That leads to a 97% survivability rate after 10 years.
I will still be able to eat fresh fruit and be around flowers. I must avoid crowds and sick people. Dr. Velez feels this Dana-Farber protocol is doable for me. I told him I was willing to try it but if it got to the point where I was with the four drug protocol, I would stop chemo.
I mentioned my episodes of depression and he has prescribed me Alprazolam 0.5mg tablets which should even out my mood swings. It’s actually an anti-anxiety medication that produces a calming effect. I told him antidepressants don’t work well on me and he says this will help. Of course, the pharmacy is having trouble with my insurance company on filling the prescription.
I also asked about skin tears and bruising. The four drug routine I was on previously had that as a side effect to the point they recommended you not use rectal thermometers because it might cause damage to the colon. Not to worry. I don’t use a rectal thermometer but it’s nice to know I don’t have to worry about excess bleeding and tears.
They want me to eat a protein rich diet. I really don’t have much of an appetite and haven’t been able to finish any meals lately. I did stop at the HoneyBaked ham store and got a BOLO sandwich, so two meals in one. I also purchased 2 lbs of HB Ham and froze one. I found out last week I can eat that.
I’ll also need to drink at least 2 quarts of water in a 24 hour period to flush the chemo out of my system. Neither of the two drugs seem to affect the kidneys as bad as the four drug regimen.
On the four drug regimen, I would not have been able to receive flu shots, Covid shots or when approved, RSV immunizations. I asked about that and he said it was perfectly fine to get the injections when they become available in the fall.
One handout said no ibuprofen and in the same handout, said it was OK. I checked and I can use Advil without any problem.
I asked once we are on infusions every 3 weeks, could I camp and hike. He said absolutely!
I feel this was as positive of a situation as I can possibly expect. I’ll give it a try. Now if I can get that damn drain removed!
__________
This plant is considered to be a stage 2 invasive in Florida which means its on the increase but has not affected native plant communities – yet. It’s a tropical and subtropical vine and is planted in Asia, Africa and the Caribbean for its edible, albeit bitter fruit. Here, it’s a pest.
Every time I find it in my yard growing along the fence row I rip it out. When I do, the air around and my hands have this very pungent aroma from the vine. It’s not unpleasant but it certainly isn’t good smelling either.
Most people like it for the colorful orange fruit. The flowers are very much like flowers of the cucumber, cantelope and watermelon.
I digress but there was a meme several years ago on Facebook about how to tell the ripeness of the watermelon and explained that male flowers produced a poor tasting melon and female flowers produced a good tasting melon. Tommyrot. Only the female flowers produce the fruit.
However, Momordica belongs in the same family as watermelons, cucumbers, and cantelope: the Cucurbitaceae.
The Biota of North America Program (BNAP) reports 25 genera in the United States.
| Genus/Species | Common Name | Location |
| Marah oreganus | Manroot | Muir Woods National Monument |
| Marah fabacea | Manroot | Muir Woods National Monument; Pinnacles National Park; Santa Rosa Island, Channel Islands National Park |
Stay tuned!
