Wednesday, April 27, 2011

Chemotherapy. Day 1

I arrive at The hematology Oncology office almost promptly at 8:03.
I sign in and sit and wait. Apparently Wednesday is the busiest day and they have added Dr Rao to the practice and he brings 125 patients.
After about 25 minutes, they call me to the lab. I refuse to submit to more labs because Dr Flam ordered the labs at St Agnes to be done Monday, just 2 days earlier, after a discussion which went something like this.
Dr Flam: You'll need labs before the Chemo. I could just get them here or at St Agnes since you'll probably need labs before they place the port.
Me: OK, let's get them at St Agnes.
Dr Flam: OK. I'll write the order.
And he did.
However, the labs are not immediately available, not having been filed in my chart.
Dr Flam: We can get them from the computer.
Nurse: The computer is down.
They did find my labs and my Hemoglobin is creeping up towards the normal range, at 11.8 from I think 11.1 three weeks earlier. 
So they will draw blood from the port for serum iron and iron binding capacity.
9:00 AM. After a brief examination, I am sent to the small room for my Chemo. There are about 5 LazyBoy chairs down one side of the room. I grab the only vacant one. There are four sofabeds with elevated knee support on the other side of the room, all empty but soon to fill up. To my left are two very large bathrooms with folding doors. I decide they are not very private and will be used only in an emergency.
A very experienced nurse named Bill checks my port. He accesses it using a special needle called a Huber needle which has a 90 degree bend and tapes easily to the skin. Before inserting the needle, he numbs the skin with Ethylene Chloride spray, and I don't feel the needle. They draw my blood and begin treatment.
I am given Aloxi 0.25 mg bolus, 
Next was Emend, 150 mg.
I am pre-hydrated with 500 cc of normal saline  to which potassium chloride (KCl)  and magnesium sulfate (MgSO4).
Sorry, I don't know the doses.
At about 10:30, they bring in the big gun. Cis Platinum 170 mg with 40 mg KCl, 12 mg of MgSO4
and 20 mg of Lasix. Lasix is a drug which increases urine production. It is used to prevent nephrotoxicity. (Kidney damage). 10 mg of decadron is also given. It is basically IV cortisone. This is in about 3000 cc of fluid, I think normal saline.
The infusion is about 3 hours. I sleep part of the time. Judy goes home and comes back at lunchtime with a sandwich from Subway, a soda and lemon yogurt.
Judy leaves to pick up my anti-nausea pills. 
Zofram (generic name is Ondansetron) 8 mg twice a day.
Compazine (generic name is Prochlorperazine) 10 mg as needed 6 hours apart.
The insurance may not cover the Zofran, about $21 for 12 pills. No biggy.
At about 2:45, The second gun arrives. 100 mg of VP16 in 250 mg of normal saline.
I lost count of the number of visits to the bathroom, but my best estimate is 7. Fortunately, I found a more private bathroom.
I must say that the first day went surprising well. I was not sick. I had no nausea. I was comfortable and I got to meet new people.
To my left was a young man, about 35, with a lovely young woman, perhaps his wife or sister. He was also receiving cis platinum.
He has a rare testicular cancer, choriocarcinoma and they have given up on trying to cure him. The treatments for him are designed for slowing the spread of already widespread disease. 
To my right was a man who was quietly playing cribbage with a woman, I presume his wife. Suddenly, he developed terrible chills and was in agony for about 20 minutes, perhaps because of an infected port. After the chills resolved, he was vomiting.
We left at about 4:15 PM.
I return Thursday and Friday for shorter sessions, just the VP16.
On Saturday, I have to go for an injection to stimulate my bone marrow. I think it is Neulasta.
I will post again about this.
After we returned home, it was a quiet evening. I have had no symptoms. I ate a good dinner, drank some fluids and we watched the Giants (they lost) and American Idol (James Durbin would get my vote if I voted).
I have now accumulated enough master points on line to become a Gold Life Master of the American Contract Bridge League.
So what did I learn today?
1. Chemo may not be as bad as I expected.
2. There are other patients who are much worse off than me.
3. I can find the bathrooms blindfolded while dragging my IV pole.

3 comments:

  1. All good learning experiences!! Sounds like a successful day!! Keep it up! Mark Alson

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  2. Haha, oh Dave that last comment made me giggle, good on you for keeping your sense of humour and well done on you first day ,(((((hugs)))) to you , hoping for only good things, your courage is evident !!!!

    Take care

    Leilani and Joe xx

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  3. HI Dave,
    There is sadness and humor in your experiences, thanks for sharing.
    My heart goes out to everyone dealing with the treatments, your humor is similar to my husband and I think it's what keeps your spirits strong.
    stay strong in mind, body and spirit.
    Carol

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