Hello Lynn,

I totally understand your concerns.  Let me share some of my story with you.

About 18 months ago I found a lump in my breast.  After a lumpectomy it was discovered that I was at Stage III and would need chemo, radiation and a mastectomy.

My oncologist told me that while the radiation would need to be done after the surgery, surgery could be first or chemo could be first, there is no difference for most patients.  I opted for chemo first.

So back to surgery - mine went well and I was lifting my affected arm over my head right away.  I have no more stiffness.  But the numbness (I assume in your chest) will remain.  Nerves to your skin were cut.  They will not mend.  You get used to the numbness after a while.

One of the beautiful things about my HMO is that each site has a breast care coordinator and all the doctors and chemo centers are part of one organization.

One recommendation I can make to you is to contact the local chapter of the American Cancer Society to find resources to lead you to someone with all the information you need about managing your care.  People like this are often available to work with you at critical points along the way for a fee.  And if money is an issue they often have a sliding scale.  It's good to have someone who is not terrified by your diagnosis or prognosis, and a third party would be just the ticket.

Another suggestion is to have someone with you at every appointment.   It's amazing how much was said by doctors that I didn't retain; my companions filled in the blanks for me and also came up with good questions to ask during the appointments.

I was also premenopausal when chemo started.  My periods had begun to be erratic, and my oncologist informed me that, for many women in my situation, the start of chemo is the start of menopause.  For me this meant that the last period I ever had was the one just before chemo started. 

Having hot flashes during chemo only adds insult to injury, but now I am officially post-menopausal and I sure don't miss my periods one bit.

Going to chemo sucks.  There's no way around it.  A couple of things that helped me: I had a helper with me each time and I brought along things to do.

Here's what chemo was like for me: I was seated in a reclining chair with lots of pillows available for my comfort.  A table was attached to the chair or next to it for me to put my stuff.  My companion of the day was in a chair next to mine and had almost no room to move around.  (I suggest finding people to come with you who aren't going to complain about it.)

I had no trouble with my veins, and when the chemo started I didn't feel much different.  Sometimes a certain drug would give me a metallic taste in my mouth.   So I sat in my chair for the number of hours it took, and I read or talked to my friend or watched a movie on my laptop.

The nurses provided juice and cookies or crackers.  There were a lot of people in the unit, and many of them seemed decidedly more sick than I.  Some of the women were wearing lots of makeup and nice wigs; some, like me, were just comfy.  It was hard to see the children getting chemo.

The best technique I found for getting through the chemo infusion was to concentrate on anything interesting that didn't have to do with my cancer.  Sometimes I meditated, other times I talked to friends on the phone.  If I had to be in the moment it was so very hard to sit still.  Think of it like dental surgery - it's hard and kinda gross but it will be over soon.

Everyone has some kind of reaction to chemo, and it's different from one person to the next.  Part of it is which particular chemicals they're putting in your body, and part of it is your general health and your attitude.

I found my doctor and everyone in the chemo infusion unit was particularly nice and really wanted to know what kinds of issues I had.  There was even a number to call any time, day or night, for advice or a prescription. They are trained to hear our complaints and take them seriously.  Don't put on a happy face if that's not what you're feeling.  This is the right time to be as ornery as you need to, whatever gets you through the day.

Also, since I live in California, I was able to take advantage of the use of cannabis (marijuana) for my symptoms.  It made a huge difference.

On to radiation.  This is the easiest part of the triad.  After some initial visits to establish how your treatments will go, you'll find yourself going to appointments every weekday for 4, 5 or 6 weeks.  Some folks get to have larger doses of radiation on a completely different schedule.

The hardest part of each day of treatment is all the undressing and dressing you need to do. Seriously, once you are ready you'll be in and out of the treatment room in a matter of minutes.

Side effects of radiation include radiation-burn which looks and feels like sunburn, and ongoing fatigue.  My radiation oncologist suggested particular ointments that would help to mitigate the worst burn symptoms, and if you use an ointment as often as you can you may well be able to avoid a really bad burn.  I am 8 months post-radiation and I still have a rectangle of darkened skin on my chest.

The fatigue is another story.  It may not hit you for several weeks into the treatment series, but practically everyone I know who's had radiation has felt it.  Again your general health and your fitness and attitude play a huge part in how the fatigue hits you.  I was decidedly tired and had to go to bed very early every night for months afterwards.

Then one day I woke up and I just knew, somehow, that the fatigue had ended for good.  It doesn't taper off, it just stops abruptly at some point.  I was told to expect this but I never imagined it would happen quite this way.

I hope I've answered some of your questions, and please feel free to be in touch with me if I can help further.