Preparing for Treatment: Hair Cut & Zoladex

Scalp cooling

Given the size and type of breast tumor, I learned that I was recommended to receive the Taxol + Herceptin regime. Taxol is a chemotherapy drug that attacks all of the fast-growing cells in my body. While that is a good characterization of my cancer cells, it is also similar to many other fast growing cells in my body like hair, nails, etc. This is why many people who undergo chemotherapy will lose their hair. Luckily for me, the Taxol is less harsh than other chemo regimens, so there is a chance that I will not lose all of my hair. However, one way to decrease the chance I lose my hair is to wear a super-cooled cap that looks a bit like a blue brain with a neoprene-like cap on that. It continuously pumps super-cooled liquid through the cap to keep my hair follicles very cold. I do not know the detailed science behind it, but I believe it keeps your follicles from receiving as much chemo drug, so your hair can be preserved.

Unfortunately, it’s not like I’m going to keep 100% of my hair. I will hopefully get to keep 60% of it. I have no idea what it will feel like to have only 60% of my hair, but I will certainly document it as I go along. I’m told that people close to me will notice my hair thinning, but strangers wouldn’t think twice about it. At the very least, the hope is that my hair thins and doesn’t come out in big chunks, which would probably be very upsetting. Also, the company that is providing the cap says that even if you do lose your hair completely, the scalp cooling can help protect the hair follicles and regrowth can begin sooner than without scalp cooling. Again, we will see!

Contingency planning

In preparation for my chemo to start, I was encouraged to cut my hair shorter to decrease the chance it tangles, make it more manageable and, if I lose it, there will be less to lose. I had already been thinking about this before I knew exactly what chemo regimen would be recommended. My hair was pretty long and I figured I would need to take some interim steps to cutting my hair in preparation for potentially losing it completely. So I made an appointment with my hair stylist! I have been going to the same hair stylist here in Baltimore for 7 years, Jessica Avant, who works at Neon Hare. She is absolutely awesome!

Each of these appointments and steps take me another day closer to the start of my chemo. It isn’t exactly something I’m looking forward to, but I’m trying to get myself psyched up for it.

Fertility protection

While I would also like to preserve my ability to have another child if I chose to do that, as a young woman, it is still important to me take reasonable steps to protect my reproductive organs. Many young women facing similar circumstances to me have two primary choices (that I’m aware of). You can either choose to see a fertility specialist who will help you to harvest eggs and freeze. This option usually delays treatment because you need to find a fertility specialist, get an appointment and then go through the steps you need to do to stimulate ovulation and then collect those eggs. While my tumor is not estrogen or progesterone receptor positive, many woman do face that situation so fertility treatments come with the risk of fueling tumor growth while you wait to harvest your eggs. I really didn’t want to delay my treatment any more than necessary, so I didn’t choose this option.

The second option is to get an injection like Lupron or Zoladex. Again, I’m not a doctor, but my understanding is that it works by “turning off” your ovaries while you are undergoing treatment so that they are not damaged. Your eggs are another type of “fast-growing” cell in your body, so they are especially vulnerable to the chemo as well as the whole process of your ovaries releasing eggs. Hopefully, with this treatment, it will protect and preserve my ovaries for my longer term health.

Getting the injection

A quick, humorous situational story

When I arrived at my appointment, no one was at the front desk and I was the only person waiting. I had completed all of my online check-ins, so I pulled out my book and figured someone would be out soon. While I waited, an older man finished up an appointment and was standing at the empty desk to check-out. Then an older Lady Number 1 showed up with her daughter for an appointment. And finally, Lady Number 2 shows up for her appointment with her son. It was clear all of these individuals were regulars. Keep in mind, my appointment (as well as everyone else’s appointment) was 11 am.

Lady Number 2 was getting really irritated when it was 11:02 am and no one was there. She proceeds to call someone to ask them about it. She explains the situation and says no one is at the desk to check them in. Then, the most predictable thing happens – those individuals call the front desk. Lady Number 2 gets pissed.

She turns around to the rest of us holding up the cell phone like we could hear the hold music, “She just couldn’t listen to me! I told her that no one was here. You all see that no one is here!” She gestures behind her at the empty front desk. She turns back to her phone and starts with “Honey, honey, you did not listen to the first thing I told you. No one is here…“

Meanwhile, her son is somewhat embarrassed, “Come on mom, they’ll be back.”

However, something amazing happens. She inspires the daughter of Lady Number 1 to piggy-back off of another patient going in the “restricted section” announcing to all of us that she’s “going back!”

She returns a few moments later to let the whole group know that she spoke with “Caitlin” (can’t be sure on spelling). Someone who is not Caitlin comes to the desk and totally blames another lady who was supposed to be manning the front desk. Then Lady Number 2 announces, “People have been waiting to get checked into their appointments! This young lady [gesturing at me] has been waiting!”

I look around unsure that she’s actually talking about me, but then realizing I am the only “young lady” nearby. While the whole thing was quite comical to me, I have to appreciate their assertiveness – it helped me to get to my appointment relatively on time. By this time, it was 11:07 am.

Actually getting the injection

Like all of my other appointments, I cried at this one when the nurse explained to me this was an injection and not a shot. I’m not sure I can reliably give an accurate definition of the two, but it was clear the one, big difference is that an injection would involve a larger needle.

The nurse who did my injection was absolutely wonderful. She was kind, sweet and very patient with me. She warned me that she couldn’t numb me, which hadn’t even crossed my mind. She handed me a bag of ice and told me to hold in on my stomach until it got nice and cold. They would need to give me this injection, in my fatty abdominal tissue.

After about 5 minutes, she pinched me where she planned to inject the Zoladex pellet and asked if I felt it or if that hurt. I could both feel it and it hurt when she pinched me, so we decided it would be best to numb it for another 5 minutes. When she gave me the injection, it was actually a million times better than I was anticipating – under promise, over deliver. It went very quickly and it barely hurt. Maybe the needle was bigger, but it wasn’t what I had built up in my mind.

So to anyone who needs to get one, it’s really not that horrible. Icing it for 10 minutes really did make a difference. The nurse told me that when you ice like that, your blood vessels constrict, which ends up making it harder for your blood to clot. You will bleed a little more than when you would just get a normal shot in your arm, but it’s really not bad at all. I do have a super nasty bruise from it, but it’s not too bad.

Another step closer…