Worst Shot EVER!

On February 25th -- two days after I returned home from Florida -- it was time to go back to the doc's for another check-up. My main concern that day was whether or not my recently pneumonia-racked immune system would be able to withstand yet another flight in just two more days (specifically my flight down to Dallas for the YSC conference -- which I'll write more about in another post).

Weirdly enough, I actually wanted my oncologist to order me a Neupogen shot. (For those who don't know, Neupogen is this drug they give to people whose white blood cell counts are too low, usually a result of chemo or -- in my case -- radiation.) There was no way that I was about to miss that conference; however, I'd only been out of the hospital for two days, and I sure as heck didn't want to get sick again, either! As painful as a shot in the abdomen might sound, I do have faith in old Neupogen and its ability to boost my counts high enough to protect me from any nasty, unwanted infections.

So the day before my appointment, I called my onc's nurse to explain that I was traveling again, and to see if she could give me the shot. I got some vague answer in response to the Neupogen. HOWEVER, she told me that I was scheduled for something else the next day; something called an "Eligard" shot. I'd never heard of such a thing. But after she mentioned it, my mind thought something along the lines of: Eligard... GUARD?

So somehow, I concluded that this must be another kind of shot to "guard" me against infections. I thought, Oh, that'll do. Who cared if I got Neupogen or Eligard, as long as whatever shot they gave me kept me from getting sick again while traveling?

I wasn't nervous at all when I first heard about the mysterious Eligard shot. Little did I know what lay in store for me in less than 24 hours!

The next morning, Merwyn dropped me off at the clinic. I was a little early, so I sat for awhile in the waiting area with a book and some tea. At 9:45, I went promptly over to my "favorite" place, The PacLab, to get my blood drawn. Because of the pneumonia, I had to wear a stupid mask when they were jamming the needle in my arm. Other than that, though, the "lab" was quick and uneventful. I've gotta give PacLab credit -- they're very efficent at what they do (and their blood draws hardly hurt at all!).

After labs, it was time to meet with Dr. Ye. He briefly mentioned the Eligard shot, and told me his nurse would administer it for me after he and I took care of some other business. At some point during this chat, I finally realized that Eligard had nothing to do with white blood cell counts or immune systems; it was actually another version of Lupron, this "ovarian suppression" treatment that he'd told me about at my last appointment. I already knew I'd be getting regular Lupron shots; I just didn't know that I'd be starting them that day. No worries. I may loathe needles, but still. You've felt one shot, you've felt them all, right?

Well, before I could experience the real joys of Eligard, I had to go across the building and get a chest X-Ray to make sure there was no pneumonia left in my chest. This process took awhile. Most of that time consisted of me sitting around in a chair. (Thrilling.)

But when I finally returned to Dr. Ye's office, he was ready with some news for me. The X-Ray did indeed show just a tiny bit of pneumonia lingering in my lung. Dr. Ye prescribed five more days' worth of Amoxicillin, "just in case." Then he told me that I didn't need a Neupogen shot, after all. My blood counts were in the "normal" level.

After hearing all this, I still felt a little worried about my upcoming trip, but the doctor assured me that traveling should be just fine. I knew he couldn't just hand out Neupogen like candy, so ... whatever. If I didn't need it, I didn't need it. I decided to take his word on this.

The next order of business was Femara, an "aromatase inhibitor" that's supposed to block estrogen (my cancer's BFF). Dr. Ye gave me a sample bottle with 30 of these pills and told me to start taking them on a daily basis beginning March 1st. After that, we talked about Zometa, this bone-strengthening drug (the one I had to go to the dentist for back in January, so I won't get osteonecrosis of the jaw.) Dr. Ye told me I was scheduled for a 15-minute infusion of Zometa on March 26th.

We chatted a little bit more, mostly about my upcoming appointment at the Seattle Cancer Care Alliance, and then finally -- it was time to head toward the back office for ... my Eligard shot.

Dr. Ye's nurse was already back there with her tools. She held a syringe in her hand, and I could see the box that said "Eligard" on the counter right next to her. I didn't really want to watch her prepare the needle, but I felt I had to make conversation. So I asked something along the lines of, "So, where do I get this shot, anyway? My stomach?"

Nope. The nurse smiled grimly and pointed to her "rear end."

Uh-oh!

I chuckled awkwardly for a moment or two. So did the nurse. I could tell she wasn't thrilled about this part of her job. (Did I mention that she's Dr. Ye's only nurse, at least at that particular office?) Finally, after a few more minutes of awkward chuckling, I asked the next, most logical-seeming question: "Does it hurt?"

I expected the usual spiel ("Well, you'll feel a little poke...") and was horrified when she instead began to tell me the story of how much her last patient hated his shot, and how painful it was. Not only that, he was the first patient she'd ever given this shot to ... which made me only the second!

Well, any ambivalence I might have felt about Eligard was long gone by this point. To make matters worse, she warned me to NOT look at the needle (like I really would have). And speaking of that needle, she was taking forever to prepare it. And I had no idea how to prepare for my part in the injection. Was I supposed to just bend over the chair? Somehow, I didn't think so, but ... what did I do? I didn't want to stand there with my pants down yet if it wasn't necessary.

Eventually, she had everything ready, so I finally did pull down my pants and leaned uncomfortably against that chair. I guessed she must have swabbed the injection site with alcohol; I don't really remember. What I DO remember is a pinch, followed by the words "I wish I could tell you that this doesn't hurt!" And wouldn't you know, right as she said hurt, the needle went into my skin.

I wish I could tell YOU it didn't hurt, but the next several seconds were seriously the most painful seconds I've ever felt, shot-wise. The initial jab actually made me cry out, "OW!" That was followed by a VERY brief moment of painlessness --but just as I began to think, Maybe this isn't SO bad, I began to feel this horrible, awful, deep, stinging pain down at the injection site. The nurse made the moment oh-so-much better by telling me how this was a thick medicine, slow to inject, and that's why it hurt so much. Oh -- she also spilled some on me, which I'm sure really "helped" with the pain.

Really, the only quote-unquote "good" thing about the shot was that it seemed to be over relatively quickly (despite what the nurse said about the drug being slow-to-inject). Next thing I knew, she was putting one of those circular band-aids on the injection site, and then I was able to pull up my pants again and go about my day. The nurse kept on telling me, "I'm sorry! I'm sorry! It's only every 28 days!" The thing is, she was so nice in the way she went about giving me the shot. I mean; I wish she hadn't told me how much it was going to hurt, but I could tell she didn't want to hurt me. I think she just wanted to be honest with me. And after joking with her about it some more, and feeling so relieved that the dumb thing was done and over with, I actually left Dr. Ye's office in a pretty good mood that day.

Well, with most shots, I usually forget about them immediately. Occasionally, I'm sore from a shot for the rest of the day, and then I forget about it by the next day. I was still sore from the Eligard when Merwyn picked me up, but I figured the pain would go away by the time I went to sleep that night. I made sure to tell Merwyn how awful it was; but otherwise the Eligard experience moved temporarily to the back of my mind...

Until the next morning. That's when I noticed the spot was still sore. And it was still sore the next morning ... and the next...

The pain from that darn shot stayed with me for the next several weeks! In fact, it's STILL noticeable! I wouldn't call it excruciating pain, but the spot is definitely sore (especially if I lay down right on it) -- and to top everything off, there's a hard little KNOT there right where she slid the needle in! It itches sometimes, too. I keep wondering, is this even normal?

Last Thursday, I visited an excellent oncologist at the Seattle Cancer Care Alliance and she confirmed that, unfortunately, the side effects from my Eligard shot are indeed normal. (Though she wondered why I'm receiving Eligard instead of Lupron. Me, too. The drugs are basically the same thing, but there are differences -- such as Eligard is usually known for being prescribed to men with prostate cancer, whereas women who need ovarian suppression treatment are usually prescribed Lupron. So why am I getting the Eligard?)

I don't know, but it's really discouraging to think that I might have to have these shots on a monthly basis for the rest of my life. The more I think about the shot I received, the more I realize how traumatizing it was. In fact, my next Eligard injection is scheduled for Thursday (along with my first Zometa infusion) and needless to say, I'm dreading that day like crazy. It's going to be the doctor appointment from H*LL! I hope I at least get a different nurse to give me my Eligard. The one nurse really is nice; I just really don't want her around me with that particular drug. Maybe one of the nurses at St. Pete's can give it to me. (But I know it will still hurt.)

Fortunately, SCCA offered me a light at the end of the tunnel; the oncologist I talked to there last week strongly recommended an "oophorectomy" (removal of the ovaries) instead of ovarian suppression. I'm with her 110%! I don't think my own oncologist is necessarily crazy about this idea -- I think his hesitation has something to do with the "having kids" factor (but Merwyn and I have known for years that we're going to adopt). Ultimately it's my choice, and the surgery is the choice I'm going to make. I'd rather just have the stupid ovaries taken out forever -- then I'll never have to worry about ovarian cysts (which I'm prone to), or excess estrogen (no, cancer, you CAN'T have it!). And best of all, I'll never have to worry about another horrible, horrid Eligard shot!

I do have to wait awhile for this; what with the wedding and our honeymoon in Europe coming up, it's probably best if I postpone the procedure until summer. But then it's surgery time for sure!

I suppose I can withstand another Eligard shot or two (or three), knowing that soon enough, they'll be a thing of the past... I'm not going to love them, but at least now I know I don't have to dread them for the rest of my life!