14 June 2024
I forced myself out of bed this morning about 6:20 and started my morning walk with overcast skies. I decided discretion was the better part of valor and instead of my trusty walking stick, I took an umbrella.
About 0.1 mile into my walk it started sprinkling. By the time I hit 0.2 miles, it started to rain and I was glad for my umbrella. I turned around and it continued to rain. I made it back to the house and it’s only stopped raining for the last few minutes. It’s 9:12 now so we’ve had about 2 hours of rain and drizzle.
Broward County reported some places got 20 inches in 24 hours. Hallandale and Hollywood were the most affected. One real problem was people driving through the water and sending wakes that would go into the homes along the road.
As you might guess, I messed up the order of sandwiches to the cancer center. There were two orders and the first order was delivered OK. The second order came to my house. I had to send the poor driver all the way across town to Holy Cross. Kathy, the Nurse Navigator called to profusely thank me. It was the least I could do for all they have done for me this year.
Since I’m getting some conflicting signals from several sources about the Herceptin treatment, I made the mistake of trying to get educated on the subject and I Googled “Herceptin and ejection fraction.” I read a couple of scientific papers on the subject. I then tried to find the original paper on the Dana Farber study about 17 or 18 treatments of Herceptin every three weeks apart. That’s pretty much a year of treatment. I couldn’t find the paper.
What I didn’t anticipate was how aggressive my cancer was. The HER2+ transmembrane protein is what the virus attaches to. Herceptin is like a blocker to the protein so the virus cannot attach. However, the HER2+transmembrane protein is found everywhere in the body, and, as you might guess, in the heart. That protein is necessary for the proper functioning of the heart so when you block it, it can lead to heart problems. They most often mention heart failure.
There are some studies out of the UK that suggest less than 17 treatments is OK and there are studies of the US that say that’s dangerous not to do the 17 treatments. Both are backed by data and methodology. What it boils down to is no one knows for sure if my missing 4 treatments will cause my cancer to return.
In any case, on the 19th I have a MUGA scan and on the 25th I have a Herceptin treatment scheduled with a meeting with Dr. Velez before the treatment. I find myself between a rock and a hard place in trying to make a decision. Another way of putting it is do I die of cancer or do I die of heart failure. Of course, neither event may occur but that’s kind of how the literature puts it.
The one bit of good news on that front is that I am also progesterone receptor and estrogen receptor positive. That means even though I had an aggressive form of cancer, it was slow growing.
Either my research depressed me or the weather is affecting me but I don’t have any energy today. I managed to drag the yard waste bin and garbage bin back from the curb and into their places in the side yard. I canceled physical therapy for today. I just couldn’t face that.
Farah, Dr. Jellinger’s assistant (endocrinology) faxed the bone density prescription over to Holy Cross. I should get a call from scheduling today sometime.
The Jardiance Dr. Jellinger put me on comes with all kinds of precautions. If my glucose level drops, dial back the insulin pen. I’ll pee a lot for the first two weeks and I need to pee onto the ketose strips to make sure I’m not losing too much sugar. It’s complicated to be on this drug.
I know I worry some of you with my dour and muddled look at things but I’m really OK. Like anyone going through this, I have good days and bad days. The good news is the good days do return.
The one thing that did startle me was in conversation with Dr. Jellinger about the effects of Herceptin and what Jardiance can and can not do, I mentioned I didn’t care as long as I could still hike. He looked at me, then away and didn’t respond. Maybe I’ll get a motorized wheel chair with tracks instead of wheels. Then I could go over any terrain.
Stay tuned!
