Round 2 Chemo: 4 of 6 Infusions – DONE!

Great news! Infusion done! And some good things this week:

• Meeting with Medical Oncologist
  • PD-L1 – My Medical Oncologist ran the test to see if I’m PD-L1 positive and I am! This means, if needed (which hopefully I don’t need it), I am a candidate for an Immunotherapy targeted for TNBC / PD-L1 positive and has shown great results. I think this is the drug: Tecentriq
  • NGS Testing – He is going to see if we have enough biopsy samples to run the NGS testing, if not we can see if we have enough at surgery (but hopefully not enough cancer is present).  This test is just more information.  
  • Progress – There are no new lumps and so far the skin hasn’t show any other signs, we’re looking good. 
  • Biopsy Site – Dr. said it looks good – it’ll take a while to heal but it’s looking better. Plus we’ll cut it off in a few weeks anyway. 
  • We pushed back my scan until the week after chemo – this shouldn’t impact the schedule
  • My blood cell counts looked great which was also good news
• Infusion
  • Infusion went great – I had my new favorite nurse who nailed the IV in one try.  
  • It was a tad slow, but overall went very well. 
  • My only side effect so far is sleeping the first few nights after they give me the steroid.  I was up until 3AM last night.  Luckily Aubrey is around for texting. 
• Meeting with 2nd Opinion Surgical Oncologist from Emory
  • Met with the SO I considered when I started my journey. I really like him, he’s super positive and confident which works well with me.  He’s also a plastic surgeon and surgical oncologist, and the director of Surgery at Emory.  He has a lot of years of practice.  
  • I like that he can both think about reconstruction and cancer removal, which will help since we’re taking so much skin
  • I’m considering switching to him, my Medical Oncologist mentioned he has worked with him as well as has my physical therapist. 
  • He confirmed my plan.  He is recommending taking out my left expander completely to make radiation easier.  He also said it would probably be a year before reconstruction to ensure the cancer is gone and I have lots of time to heal from radiation. He did say we always have the option to remove all the skin if needed.  
• Physical Therapist – I met with my new physical therapist Friday.  It went very well! She is extremely well versed with breast cancer and the treatments and ailments.  She did an assessment and has our plan. 
  • I have decent movement in my right arm and my left has a little way to go
  • I need to be careful with my left arm as it’s at risk for lymphedema.  It’s a low risk since they haven’t removed any lymph nodes, but the radiation and biopsies put me at risk.  We took measurements to watch for swelling. I also shouldn’t do blood tests, infusions or blood pressure on the left side. 
  • We talked through the right ways to walk and sit at work as to not cause more back pain etc. 
  • Exercise – we’re going to work in exercise.  Keep the walking but replace it one day a week with gym to build muscle with arms/legs/core and Saturday when Grace is in ballet head to the gym near by.  If I’m traveling try to do some online videos or head to the gym.  We said 30 minutes is good enough. 
  • Stretch – We need to regain movement, so first we will work on stretching then focus on strength. I will see her 1 time per week for 5 weeks and each day have 3 arm stretches to do.  They were pretty painful.  She measured so we have before benchmarks! 
  • After we complete this cycle she said I have the stretches to use after any surgeries, and if it worsens then I would come back. 
  • She also knows my whole Dr team and acupuncturist so I’ve just added another awesome resource to my team. 
• In other news – I got a sharps container with my injection refill… cool stuff
• Now on to my week of vacation!