Herceptin's Bittersweet Goodbye

March 9, 2015 marked a day that will be etched in my mind forever.  The week before had been a whirlwind of preparations for this day...MRI's, a surgery to place a port in my chest, a bone scan, a chest/abdomen CT scan, consults with doctors, and a trip with my girls to purchase a wig for the day my hair began to fall out.  Notebook and pen in hand, I had met with my oncology nurse friend in order to prepare for the side effects that would begin on this day.  My longtime childhood friends came to visit and encourage me.  Bryan and I sat in our sweet friends' living room while our troops prepared us for battle by praying over us...countless friends and family who lovingly brought us before the throne of God, pleading for grace to be given for the journey.  Food was shared, tears were poured out, cards were penned with beautiful words to encourage and prepare us.  Selfless women in my life surprised me by cleaning EVERY square inch of our home in order to keep germs at bay for my soon-to-be fragile immune system.  I packed a trendy little bag given to me by friends and filled it with magazines, mints, Jolly Ranchers (both of which were supposed to help with the terrible tastes I would experience), and a new blanket made especially for this day by my dear neighbor.  Bryan and I, in our limited foreknowledge of the road before us, prayed for the strength to go to war.

The morning of March 9th, I picked out clothes that would allow the nurses easy access to the port in my chest.  Quickly, I learned that camisoles with zip-up sweatshirts and yoga pants would become the standard attire for these events :)  I was nervous, understanding that the "healthiness" that my body seemed to be experiencing would give way to a sickness I had never known.  Would the chemo hurt as it entered my body?  How long would it take to begin to feel the ravages of these necessary, yet harsh medications?  I appled lydocaine cream to my port, covering the site with a small piece of Press-and-Seal wrap, hoping to ease the discomfort of the needle they would use while accessing it.  Looking back, I really could not have adequately prepared for what was coming, no matter how hard I tried.  Experience would be the only truly effective teacher.

After seeing Dr. Jones, my oncologist, Bryan, my mom, and I went next door to the Good Sam infusion center.  Vanessa, Renee, and Tina, who would be the valiant nurses that would administer my chemo through the next year of my life, greeted me and led me to a grey reclining chair in the back corner of the room.  Several other patients were scattered throughout the small, yet bright and airy room, most of them sitting next to loved ones who came to walk through the dreadfulness with them.  Following a brief explanation of what my 6-7 hour regimen would entail (5-6 hours from here on out), they brought me warm blankets and made me comfortable.  Although I didn't realize it at the time, these nurses were teaching me the dance that is chemo, one in which I would soon learn the steps of so well.  And as terrible as it would quickly become, there was a certain predictability to its rhythm that I would grow to appreciate.

After the premeds were administered, along with my first chemo drug, the nurses began running my second chemo drug, Herceptin.  This rockstar part of my regimen would be a crucial weapon in my fight against the HER2 positive status of my cancer.  My mom had left to pick up our kids, and Bryan and I were resting comfortably, playing cards.  Very quickly, however, something seemed off to me.  I was experiencing terrible cramping and nausea, which I assumed was attributed to the chemo (although I had heard that didn't typically begin until a couple of days later).  My body was also shaking, as if experiencing severe chills.  The nurses were aware and were keeping an eye on me, yet I was feeling discouraged.  Was my body weak and unable to handle the chemo?  Was this normal?  Did I need to get tougher?  All of a sudden, something seemed to flow from my abdomen up through my chest, into my esophagus, and up to my throat.  I coudn't breathe.  As in, I really couldn't get a breath.  It felt like I was choking.  Vanessa, Renee, and Tina immediately came to my side, and I just remember grabbing Vanessa's arm asking her to please help me.  They turned off the Herceptin (which was almost finished), gave me two steriod injections, and called for Dr. Jones.  I was terrified.

Quickly, they had the situation under control, and I felt so much better.  The cramping, nausea, and chills were gone, and I could breathe again.  However, Dr. Jones and the nurses made the unilateral decision to stop treatment for the day.  Apparently, I had experienced a severe allergic reaction to the Herceptin.  I cried and pleaded with them to finish the remaining drugs because I knew that my body needed them.  It was the first of many times that my doctor made a decision that showed the depth of his knoweldge and the strength of his conviction to fight this cancer for me.

Returning the next day, with my body well-rested and by God's grace, we were able to finish the remaining drugs in my regimen.  And three weeks later, Dr. Jones figured out a way to still administer Herceptin, which ended up ultimately being the heavy lifter that took out my cancer.  I would visit the infusion center well over 20 times over the next year, receiving 6 full chemo treatments (4 drugs each time), 12 Herceptin only infusions, and several other infusions of fluid, Potassium, and Magnesium.  3 weeks is the most time that has passed between an infusion, and as difficult as that has been to fit into our busy lives, it's become a dance I can now do in my sleep.  Dr. Jones, the nurses, the other patients who have sat beside me through this war, have all played a role in literally saving my life.

So saying that today, my very LAST Herceptin infusion, was bittersweet feels like an understatement.  Obviously, it is a GOOD day when you realize that there will be no more port accesses, no more sleepiness from the infusions (Herceptin was relatively side-effects-free), no more child-care to arrange and two hour blocks to schedule in every 3 weeks, no more in-your-face reminders that you are/were a cancer patient.  It marks the end of the course of treatment that Dr. Jones set out to complete for me back in March 2015, and it worked!!

Yet, it's the dance of life I've also come to know, and there is some strange comfort in that.  Knowing that they were still treating the beast that had taken up residence in my body provided some security, and my doctor acknowledged that the safety net is now being removed.  I will continue to see Dr. Jones every 6 months for the next 5+ years (along with my surgeon, probably staggered every 6 months with him), yet the indicator of a cancer recurrence will now somewhat rest on me.  There will be no scans to complete because I had a double mastectomy.  And since there is no early detection for metastatic breast cancer, it's not effective to do any other scans until symptoms present themselves.  Hopefully that will never EVER become a reality for me, but I now have to monitor and report any symptom that lasts longer than a couple of weeks.  And without Herceptin to guard me, that feels like a sobering thought.

Those thoughts woke me around 3:00 a.m. last night, and desperately tried to suck the joy right out of my heart.  Here were some of my responses this morning in my prayer journal...

I know that there is now a heaviness in our lives that will likely remain, one that hopefully will not steal our joy or hover over us causing fear.  Yet this part of us all will be marked.  This makes me sad, particularly for my precious husband and children, yet you KNOW it is ultimately for their good and your glory that they walk forward with this burden.  Their wife and mom have had cancer.  Cancer is a known enemy...a destroyer.  Yet we do NOT know that it will ever return again!  For now, you have given us victory, and I pray we will rejoice and cultivate happy hearts in that.  Being that my last treatment is today, it feels like I'm walking in to the abyss of the unknown from here.  My doctors will have me "on surveillance," so they say.  They will monitor my body and seek to keep this beast away.  But my body will now be on its own to fight.  Please make it strong, oh God.

But more than anything, please quiet my heart before you.  You created the universe.  You've put kings and rulers into power and removed them.  You told the oceans where to stop and placed each star in its proper location.  And you created me.  Each organ of my body and every cell that resides in me is also under the mighty authority of YOU.  You knew cancer was there before I did.  You wrote all my days in your book and you know when I will breathe my last.  You know that about all of us.  Father, may I find rest in knowing that I don't have the power to control my cells, but you do.  And I can trust you will work all things together for our good and your glory.

So, that's where we must go from here!  Walking each step, living each day with joy, knowing that He is in control.  Taking our thoughts captive (sometimes moment by moment), and cultivating happy hearts in the victory that God has provided.  And ultimately, praising Him that the true victory has already been accomplished through Christ's death and resurrection and the eternity of everlasting joy that awaits those who put their trust in Him.

As Renee and Vanessa were getting ready to start my Herceptin today, they began the drill that they complete each and every time they administer a drug.  They scan my bracelet and ask me to give them my name and date of birth.  Every time.  Even for Tylenol :)  We always laugh, especially when I'm in the middle of a chemo-induced nap and have to wake up to walk through the drill.  Today, as Renee got ready to ask me my name, it hit me.  This would be the last time I would give these answers.  I would walk out of that room after the infusion, and hopefully never be back.  The emotion of it all overwhelmed me, and I couldn't get the words out.  I always say that certain things that I would assume would be so difficult end up easier, and it's the little things that seem to knock me off my feet.  Today was one such moment.  I couldn't get my name and date of birth out because I was choking on tears.  I looked around at that room...the room where I dove into the throes of cancer and have come out on the other side.  The room where multiple people accompanied me to my treatments, resulting in some of the sweetest conversations I've ever had.  The room where I watched others suffer and, hopefully, learned a whole new level of compassion.  We all had a good few minutes to take in all of the heartache, and yet all of the beauty, and just cry.