Battle Damage Assessment and Repair

 

Yesterday, I arrived at my 10:30 infusion appointment and was taken into a private room instead of a “cubby”. Eventually the nurses came in and told me I had to meet with the pharmacist before we could do anything. They said I had elevated liver enzymes (which I already knew from the online patient portal results) and that they couldn’t proceed until I had a consultation.

We waited and waited, and finally the pharmacist came in. As you can see from the above picture, my numbers appear to be WAY out of range. However, he explained that the “ALT” enzyme was approximately 5 times the upper reference range limit, the “AST” enzyme was only about twice the upper limit, and my bilirubin levels are in the proper range. According to the paclitaxel toxicity guidelines (paclitaxel is the specific brand name for my Taxol chemo treatment), as long as the liver enzyme levels are less than 10 times the upper limit, and the bilirubin levels are less than 1.75 times the upper limit, I am not considered in the toxicity range and do not need any changes to my treatment plan. This was a big relief, as I thought I was going to have to go home without getting treatment yesterday.

If my levels do increase to the unacceptable range, they will have to lower my dose, but so far, I’m still ok. 

As a bonus, we got to stay in the private room for the entire 6 hours that we were there, which was pretty awesome! It even had its own bathroom!!

Now that I’ve had my first 2 Taxol appointments, I was finally “allowed” to schedule with the radiation oncologist. My appointment is scheduled for May 9th, assuming that I don’t have any delays with my last 2 rounds of chemo. I will meet with the nurses, then have a mapping and simulation, and will FINALLY find out what my radiation plan will be. Radiation will then begin 1.5-2 weeks later.

My plastic surgeon also wanted to see me after I finish chemo and to find out my radiation plan- as that will likely affect my reconstruction (both the work that has already been done and what will be done in the future). That appointment is now scheduled for May 11th.