The transition from Kadcycla to Abraxane has not been an easy one. First, I had trouble with my platelet counts being too low to get chemo. Suddenly, I was seeing problems with my WBC counts and neutrophils. I would go in for chemo and be sent home to “wait one more week.” When it finally seemed like things were going to get on track and I’d had a few doses of Abraxane, my creatinine went sky high which meant that something was going on with my kidneys.
After 9 hours in the ER one day, we were sent home and told to drink more fluids. Um, okay. I got a dose of Abraxane the next week after my creatinine lowered, so we thought it was a fluke thing. But the next week was worse– my Creatinine was 4.9, when it should be around 1.0. They gave me 2 units of blood and arranged for me to be admitted to the hospital the next day. 2 days in the hospital got me fluids, magnesium by IV, another transfusion, and no answers about my sudden renal failure. Again the creatinine was lowering on it’s own, so they sent me home.
After much investigation of my entire medical history, the best they can come up with is that Abraxane was causing problems to my kidneys. The weird thing, though, is that this has never been reported before and Abraxane is processed by the liver, not the kidneys. But it’s the only thing that seems to fit right now, so we are reporting my case to the FDA and my oncologist is working on what to do next. In the meantime, I’m getting my fluids, got one dose of Herceptin, and am still planning to go on my trip to Hawaii next week. I’ll get to see my oncologist the week of Thanksgiving and hopefully by then she will have a plan ready and my creatinine will be back to normal.
This has probably been the most frightening episode since the discovery of my brain met. I find myself worrying when I try to fall asleep, wondering if my kidneys are now going to have this response to every chemo. I need my kidneys, and I need them working well. But I also need chemo. If I cannot take chemotherapy, then I’m looking at a long, slow march of trying to keep the cancer at bay with things like radiation and finger-crossing. I need systemic treatment to keep the cancer from going back to the organs.
I cannot control any of this, and once again it’s just a waiting game. If I have to wait around, I may as well do it in Hawaii. I leave next Saturday for Kona, the big Hilton Waikoloa Resort that Alex and I stayed at last year. The group includes 7 friends and one practically brand-new baby. I think the baby and I will be on about the same nap/bedtime schedule. I have my own room, we’ve got a couple of rental cars between us, and we are going to have a great time. My wonderful friend Maggie has a temp job in Bellevue that week, so she is going to stay at my house with the dogs (they LOVE her). So I am going to pay extra for the shaded, cushioned pool chair and read my book and drink some mai-tais and enjoy being with friends. The Kona coffee festival is on during the week that we are there, so that should be fun. I’m a little nervous about how uncomfortable the plane ride there is going to be… nobody likes six hours in a coach seat of a totally full plane. Because I paid for my ticket with miles, I don’t think there is any kind of option to upgrade. So I’ll just have to take my ativan, bring a seat pillow, and hope that once we get there I can walk off the plane without being hunched over in pain.
Stay tuned on Facebook for my fabulous tropical cocktail photos!