A Change in Plans

Thank-you everyone for the good thoughts and wishes; they mean so much to me! Today has been a crazy day. My "well-documented plan" on how to fight this cancer has turned on its head. I will no longer be finishing my cancer treatment with my two scheduled chemotherapy appointments, but I will instead be starting radiation.

Today I went to my cardiologist in Santa Monica and she conducted a stress test. I had never done a stress test before, so I was a little nervous about what to expect. Plus on top of that, I was really anxious because I didn't want to hear bad news. So what the nurses and doctor did for the stress test is measure my ejection fraction, or in medical terms, known as my "EF." Your ejection fraction is the amount of blood pumped out of your heart to the rest of your body. A good ejection fraction consists of a good heart squeeze, which is really what the doctor was concerned about in regards to me. During my last heart echo scan the doctors noticed my heart squeeze was not as strong as it should be, and that is a direct result of the Adriamycin in the R-CHOP of chemotherapy. So before the doctors could give me another dose of the chemo, they first wanted to make sure my heart could handle it.

First the nurse hooked me up to an echocardiograph and put heart monitors all over my chest. She then did an ultra sound of my heart and took pictures of my heart squeezing blood to the rest of my body. I then got on a treadmill with all the monitors and walked at increasing speeds and elevation. After every three minutes the treadmill would get faster and harder. Once my heart rate hit between 167 and 190, about after 8 minutes, I then got off of the treadmill and the nurses began monitoring and taking pictures of my heart once again.

After the test the doctor looked at the before and after pictures and determined that indeed my ejection fraction is lower than normal for a woman my age. So we have direct evidence that the chemo is hurting my heart. However, at this point the doctor says I shouldn't be too worried, and that hopefully I'll be fine. She is just worried that more Adriamycin could result in congestive heart failure in the future. So she plans to re-check me in three months to monitor my heart's progress. Hopefully with no Adriamycin in my body my heart will get better.

But then what do we do about the cancer? This question is of course a problem, since I still have two more chemo treatments left. So I then drove over to my oncology doctor in Westwood to get her opinion. After hearing about my heart she didn't feel comfortable giving me another dose of chemotherapy, and thought administering radiation would be a better idea, especially since I have already received four chemo treatments. My doctor says through the radiation I will still be fighting the cancer, but not injuring my heart anymore. So tomorrow afternoon I am meeting with a radiologist to plan out my radiation treatment schedule and discuss some of the side effects from the radiation.

I must admit I am a little nervous and scared about this new development. I liked having a plan, and I'm noticing that medical changes are kind of scary. At least with the chemo I knew what to "kind-of" expect and was just beginning to understand how my body reacts to the medicine. Now with the radiation it will be everyday and I don't know what to expect. It is almost like starting over, were the uncertainty of the situation is a little daunting at times. However, there are good things about the radiation- for one thing I won't have to get poked all the time! My hands will finally get a break from all of those IVs. Plus now my hair will start to slowly grow back. So as I start this new journey I'm staying positive and I know now than ever that I will beat this cancer!
Danielle