I actually felt so well on Tuesday that I was able to drive the car; attend a morning meeting and be focused and present for the discussion; run an errand to the dry cleaner and go grocery shopping. That represents a HUGE improvement over the past ten days, when I could barely move my sorry ass off the couch, and needed rides to everything. The shingles are showing a good response to the treatment, but their presence will prevent me from modeling at the Gilda's Club fashion show on Friday. It's too bad, but always better to protect the health of the other models who have compromised immune systems. The third time was not the charm, I'm afraid.
Still no word on whether the chemo combo is doing anything for the cancer. I anticipate getting my tumor markers checked again, maybe as soon as next Monday.
I was truly tired after all the running around yesterday, and noticed that my feet hurt. Not just hurt like I was tired of standing, but numb and tingly all around my toes on each foot. I think this is more neuropathy from the chemo combo. I reported it to Dr G's nurse and was told I could increase the gabapentin up to 900 mg three times a day, which is quite a bit more than I am taking now. It should help with the neuropathy pain.
I also ran some errands today. Went to Dr G's office for a shot of Neulasta to build my white blood cells, then drove north to exchange a pair of shoes (size 8.5 bought at Northgate Mall) to the size 8 (only at Alderwood Mall). I was fine with all that highway driving too.
My nose is a little runny, with a tendency to bleed (that's the Avastin), I am constipated (from the gabapentin), and I've run a very low grade fever of 99.2 degrees for the past the nights. I may be coming down with a something, and so plan to take it easy tomorrow and just go to my support group. They need to hear Jill's great shingles story.
Showing posts with label chemotherapy. Show all posts
Showing posts with label chemotherapy. Show all posts
Wednesday, June 1, 2011
Monday, May 30, 2011
Pain relief
I finally got adequate pain relief today. While waiting to get Avastin and Abraxane, the current chemo combo, I spoke on the telephone with Dr G. He decided to treat me with Lidoderm (lidocaine trasndermal5% topical patches. These are patches that distribute medication directly through your skin. The fentanyl patches are similar.
The wonderful pharmacist at the Cancer Institute, Lanny (I don't know how to spell his name), walked over to deliver the box of 30 patches to me. Our insurance coverage through Premera charged only $20 for this medication. I put one on in the middle of treatment at Dr G's request to see how well it might work while I was still in the chemo chair. Evidently the Lidoderm works extremely well, because Rik and I had a busy afternoon.
We went to the new Skillet Diner for lunch. It was not as good as I had hoped. My hamburger, ordered medium with a specific request for pink on the inside, not red, arrived overcooked and dry. There are few chances to eat poutine in Seattle, and I always jump at the chance (and am usually disappointed). Poutine is three things: fried potatoes, gravy and fresh squeaky cheese curds. The fries were terrific! The gravy, made with chicken stock, had plenty of herbs. But given that the local Beecher's makes really good cheese curds, I was disappointed to find melted cheddar cheese on Skillet's poutine. Maybe they think Seattleites don't know or care about authentic poutine?
After lunch, we picked up some bagels at Eltana. A tragedy was averted just in time -- we had run out of bagels this morning!
Nordstrom was having their half-yearly sale for women, and I really wanted to stop by while I had Rik to drive me. I did find a cute pair of black flats at a really good price. They might be a half-size too big, though, and I'd have to go to Alderwood Mall to find the smaller size. I will wait and see. Of course, while we were at the mall, I shlepped Rik into Macy's where there was also a sale, and I picked up a summer belt patterned in small squares of colors and a new purse, again in multiple colors patchworked together. It was a lot of shopping, but Rik was gracious about taking me, and I found such lovely things at good prices. Rik is the one who found the purse, and it is truly a keeper!
We came home and I watered the garden (we had two days of sunshine in a row!) while Rik mowed the lawn. Then I made us dinner of spinach and mushroom enchiladas suizas, rice and sliced fresh mango.
It's now after 9 PM and I am done for the night. I just took off the 12 mcg Fentanyl patch (it had been on for 72 hours) and removed today's Lidoderm patches. It hurt to remove them!, but we will see if I maintain good pain control overnight with the bedtime doses of valacyclovir and gabapentin. I will report to Dr G that I removed the small dose Fentanyl patch.
It felt totally terrific to be this busy for the first time in a week. I haven't cooked a meal in more than five days, ran an errand or driven the car in more than a week, or even been off the sofa this much in ten days. I know I may have overdone things (that's the trouble with pain patches, you feel good so you don't realize you do still have pain and it's easy to do too much). I may pay the price tomorrow, but there is only one item on my agenda, and I can do it from home if need be.
Time for a good night's sleep!
The wonderful pharmacist at the Cancer Institute, Lanny (I don't know how to spell his name), walked over to deliver the box of 30 patches to me. Our insurance coverage through Premera charged only $20 for this medication. I put one on in the middle of treatment at Dr G's request to see how well it might work while I was still in the chemo chair. Evidently the Lidoderm works extremely well, because Rik and I had a busy afternoon.
We went to the new Skillet Diner for lunch. It was not as good as I had hoped. My hamburger, ordered medium with a specific request for pink on the inside, not red, arrived overcooked and dry. There are few chances to eat poutine in Seattle, and I always jump at the chance (and am usually disappointed). Poutine is three things: fried potatoes, gravy and fresh squeaky cheese curds. The fries were terrific! The gravy, made with chicken stock, had plenty of herbs. But given that the local Beecher's makes really good cheese curds, I was disappointed to find melted cheddar cheese on Skillet's poutine. Maybe they think Seattleites don't know or care about authentic poutine?
 |
| Here's a shot of my poutine. At least it came as a side to the burger and so wasn't an enormous helping. |
Nordstrom was having their half-yearly sale for women, and I really wanted to stop by while I had Rik to drive me. I did find a cute pair of black flats at a really good price. They might be a half-size too big, though, and I'd have to go to Alderwood Mall to find the smaller size. I will wait and see. Of course, while we were at the mall, I shlepped Rik into Macy's where there was also a sale, and I picked up a summer belt patterned in small squares of colors and a new purse, again in multiple colors patchworked together. It was a lot of shopping, but Rik was gracious about taking me, and I found such lovely things at good prices. Rik is the one who found the purse, and it is truly a keeper!
We came home and I watered the garden (we had two days of sunshine in a row!) while Rik mowed the lawn. Then I made us dinner of spinach and mushroom enchiladas suizas, rice and sliced fresh mango.
It's now after 9 PM and I am done for the night. I just took off the 12 mcg Fentanyl patch (it had been on for 72 hours) and removed today's Lidoderm patches. It hurt to remove them!, but we will see if I maintain good pain control overnight with the bedtime doses of valacyclovir and gabapentin. I will report to Dr G that I removed the small dose Fentanyl patch.
It felt totally terrific to be this busy for the first time in a week. I haven't cooked a meal in more than five days, ran an errand or driven the car in more than a week, or even been off the sofa this much in ten days. I know I may have overdone things (that's the trouble with pain patches, you feel good so you don't realize you do still have pain and it's easy to do too much). I may pay the price tomorrow, but there is only one item on my agenda, and I can do it from home if need be.
Time for a good night's sleep!
Tuesday, May 24, 2011
Abraxane #3 plus comedy of errors
I was scheduled to have the third dose of Abraxane yesterday. I'd been complaining of low back pain and pain in my right leg all weekend, so on Monday I didn't feel dafe driving myself. What if I had more mets and was in danger of a fracture? I'd already been lucky the first time that I experienced the pathological fracture while at home and not walking the dog, driving the car, or out and about elsewhere.
So Rik drove me and I arrived extra early at 8 AM (for my 9:30 lab appointment). The lab saw me pretty quickly, but again there was a computer problem with the orders Dr G wrote and "signed" electronically while I was sitting in the room with him. The SCI nurse called his office more than a few times; his staff paged him but he didn't answer; and in the end it was almost 1 PM before they could start any of the treatment. Thankfully my friend T was there to keep me company the whole time. We got some lovely borscht and pieroshkies for lunch and eventually I got everything: Decadron the steroid, Zofran for nausea and Abraxane.
In the middle of all this I was of course still in pain. On Sunday I had taken the maximum permitted amount of Vicodin with really limited pain relief. On Monday to took two Vicodin at 8:30 Am and two more at 1:30 PM but the pain only got worse. Dr G wrote orders for morphine but I recalled that morphiine didn't help too much with pain last summer. So I ended up taking intravenous Dilaudid. Between that and a hot compress, my back pain soon eased.
The Dilaudid made feel both loopy and me nauseous and I vomited several times by the time I finished the Abraxane. So I got some Ativan for the nausea. T gave me a ride to Dr G, who wanted to see me about the pain issue. (Thankfully no vomiting in the car.) Rik met us there.
I explained all the Dr G and he sent me off for immediate spinal xrays. Given that it was 5 PM by this point and he couldn't reach an in-house radiologist, he viewed the films himself. There is an ambivalent area in my sacraum (where we already know I have mets). My pain was radiating from the lower right to the right leg and even making the skin tender to the touch, much in the way that pain from the sciatic nerve behaves. So it might be sciatica or it might be mets. Dr G wrote prescriptions for Fentanyl patches and for ketorolac (Toradol), a non-steroidal anti-inflammatory, and we went into the Minor and James pharmacy to get them.
While we were waiting, in runs Dr G. He'd reached a radiologist at Swedish hospital who confirmed that there was no danger of an immediate fracture (which would have been the reason not to send me home). He'd placed a call to my orthopedist, Daniel Flugstad, and promised to contact me today with Flugstad's take on things.
We had a mutual hug fest right there in the pharmacy -- Dr G hugs Rik, Rik hugs me, Dr G and I look tearfully into each other's eyes. No hugging, it's not frumkeit for unrelated men and women to touch outside of the doctor-patient examination. For him, not for me. But the tearful glances of relief more than make up for any lack of hugs.
Rik and I finally arrived home around 6:30 PM. I stuck the first Fentanyl patch on my arm, got undressed, ate a snack and went to bed. With Dilaudid, Ativan, and now Fentanyl in my system, I could barely stand upright. I slept well all night and woke up rested this morning.
And now for the latest news. I still have back pain. I wasn't sure at first, as it's been creeping up on me slowly all morning. I felt fine in the shower, eating breakfast, even walking the dog for a few blocks. But sitting at the computer typing and talking with the health insurance companies about bills, I've notived an increased in pain, even through the FEntanyl. So I took one of the ketorolac pills and will hope that takes care of any breakthrough pain.
I still don't have any more news about an appointment re gamma knife, but Dr G said his staff would take care of it. I learned this morning that Dr G has spoken with Dr Flugstad and am waiting for a call back from him with an update. I will, of course, report this morning's breakthrough pain. I called my primary care physican to keep her posted on all of the hoohah. And I will keep all of you posted as this comedy of errors continues.
So Rik drove me and I arrived extra early at 8 AM (for my 9:30 lab appointment). The lab saw me pretty quickly, but again there was a computer problem with the orders Dr G wrote and "signed" electronically while I was sitting in the room with him. The SCI nurse called his office more than a few times; his staff paged him but he didn't answer; and in the end it was almost 1 PM before they could start any of the treatment. Thankfully my friend T was there to keep me company the whole time. We got some lovely borscht and pieroshkies for lunch and eventually I got everything: Decadron the steroid, Zofran for nausea and Abraxane.
In the middle of all this I was of course still in pain. On Sunday I had taken the maximum permitted amount of Vicodin with really limited pain relief. On Monday to took two Vicodin at 8:30 Am and two more at 1:30 PM but the pain only got worse. Dr G wrote orders for morphine but I recalled that morphiine didn't help too much with pain last summer. So I ended up taking intravenous Dilaudid. Between that and a hot compress, my back pain soon eased.
The Dilaudid made feel both loopy and me nauseous and I vomited several times by the time I finished the Abraxane. So I got some Ativan for the nausea. T gave me a ride to Dr G, who wanted to see me about the pain issue. (Thankfully no vomiting in the car.) Rik met us there.
I explained all the Dr G and he sent me off for immediate spinal xrays. Given that it was 5 PM by this point and he couldn't reach an in-house radiologist, he viewed the films himself. There is an ambivalent area in my sacraum (where we already know I have mets). My pain was radiating from the lower right to the right leg and even making the skin tender to the touch, much in the way that pain from the sciatic nerve behaves. So it might be sciatica or it might be mets. Dr G wrote prescriptions for Fentanyl patches and for ketorolac (Toradol), a non-steroidal anti-inflammatory, and we went into the Minor and James pharmacy to get them.
While we were waiting, in runs Dr G. He'd reached a radiologist at Swedish hospital who confirmed that there was no danger of an immediate fracture (which would have been the reason not to send me home). He'd placed a call to my orthopedist, Daniel Flugstad, and promised to contact me today with Flugstad's take on things.
We had a mutual hug fest right there in the pharmacy -- Dr G hugs Rik, Rik hugs me, Dr G and I look tearfully into each other's eyes. No hugging, it's not frumkeit for unrelated men and women to touch outside of the doctor-patient examination. For him, not for me. But the tearful glances of relief more than make up for any lack of hugs.
Rik and I finally arrived home around 6:30 PM. I stuck the first Fentanyl patch on my arm, got undressed, ate a snack and went to bed. With Dilaudid, Ativan, and now Fentanyl in my system, I could barely stand upright. I slept well all night and woke up rested this morning.
And now for the latest news. I still have back pain. I wasn't sure at first, as it's been creeping up on me slowly all morning. I felt fine in the shower, eating breakfast, even walking the dog for a few blocks. But sitting at the computer typing and talking with the health insurance companies about bills, I've notived an increased in pain, even through the FEntanyl. So I took one of the ketorolac pills and will hope that takes care of any breakthrough pain.
I still don't have any more news about an appointment re gamma knife, but Dr G said his staff would take care of it. I learned this morning that Dr G has spoken with Dr Flugstad and am waiting for a call back from him with an update. I will, of course, report this morning's breakthrough pain. I called my primary care physican to keep her posted on all of the hoohah. And I will keep all of you posted as this comedy of errors continues.
Tuesday, May 17, 2011
Abraxane 2/ Avastin 2
Yesterday was another six-hour-long day at the Cancer Institute. One of the doctors was back from a week's vacation and so the lab was hugely busy, even at 9:30 in the morning. After waiting more than an hour, I finally had my port accessed and labs drawn. More than an hour after that, I was called back to the infusion chair, where eventually the nurse confirmed with Dr G that my counts, although a smidge low, still permitted me to receive treatment.
My friend G had been visiting with me until this point, and then another friend came by. We shmoozed while waiting for the pharmacy to prepare my drugs. I ordered us some luch from Mediterranean Kitchen, which J was happy to pick up.
I started the Avastin infusion around 1 PM, and it ended around 2:15 PM. (Next time the Avastin will shorten to only 30 minutes, which is where it will stay.) Then we changed over to the Abraxane (the actual chemo), which only takes 30 minutes. I was unbuckled from the chair around 3:15 and went home to crash.
I slept for three hours on the sofa, at which point I decided to just get into bed. I thought this cocktail was being given with Decadron (a steroid) AND Zofran (an anti-nausea drug), but evidently I didn't get the Zofran the first time, and there were no orders for it this time. So I toughed it out, but I was nauseous by 6 PM. I took some of the oral Zofran I have at home, and will be sure to ask Dr G today about including it in future orders.
I got up again at 9:30 and ate a piece of pizza and drank some water, then went back to bed. I was really woozy walking around the house last night, which was likely due to all the drugs floating in my bloodstream. I experienced a little abdominal pain, which is associated with the Avastin, but nothing else.
I slept until 7:45 this morning and feel better today. I took the dog for a walk and am about to head off to see Dr G and get last week's the brain MRI results. Will post more when I have info.
My friend G had been visiting with me until this point, and then another friend came by. We shmoozed while waiting for the pharmacy to prepare my drugs. I ordered us some luch from Mediterranean Kitchen, which J was happy to pick up.
I started the Avastin infusion around 1 PM, and it ended around 2:15 PM. (Next time the Avastin will shorten to only 30 minutes, which is where it will stay.) Then we changed over to the Abraxane (the actual chemo), which only takes 30 minutes. I was unbuckled from the chair around 3:15 and went home to crash.
I slept for three hours on the sofa, at which point I decided to just get into bed. I thought this cocktail was being given with Decadron (a steroid) AND Zofran (an anti-nausea drug), but evidently I didn't get the Zofran the first time, and there were no orders for it this time. So I toughed it out, but I was nauseous by 6 PM. I took some of the oral Zofran I have at home, and will be sure to ask Dr G today about including it in future orders.
I got up again at 9:30 and ate a piece of pizza and drank some water, then went back to bed. I was really woozy walking around the house last night, which was likely due to all the drugs floating in my bloodstream. I experienced a little abdominal pain, which is associated with the Avastin, but nothing else.
I slept until 7:45 this morning and feel better today. I took the dog for a walk and am about to head off to see Dr G and get last week's the brain MRI results. Will post more when I have info.
Tuesday, May 10, 2011
No chemo yesterday
My while blood cell counts were too low for me to receive chemotherapy yesterday. I need to stay away from large groups of people to prevent exposure to an infection. My friend D sat and visited for an hour while I waited for the lab results; it always feels better to have company.
After leaving the treatment center, I went straight to Dr G's office to receive my monthly injection of Xgeva, the new bone strengthening drug I've been getting instead of Zometa. I told the nurse about my week of symptoms (stupid, fatigue, runny nose and that on-the-edge-of-feeling vertigo), and Dr G came in to talk with me. Between the stupidity (which sometimes gets call "chemo brain") and the not-quite sense of vertigo, he wanted to rule out the possibility of brain metastases and ordered a brain MRI, which I haven't had in a while.
I did a little research and found that vertigo (also called Benign Paroxysmal Positional Vertigo or BPPV), can be related to treatment with gemcitabine, the chemo I just finished. Read here for more information.
So I get an extra week to recover and feel better, I'll have the brain MRI on Friday, and get the results next Tuesday.
I also learned that the Abraxane/Avastin combo is given in this order:
Abraxane on days 1, 8, 15 (of a 21 day cycle)
Avastin on days 1 and 15 (of a 21 day cycle)
I like having more information!
After leaving the treatment center, I went straight to Dr G's office to receive my monthly injection of Xgeva, the new bone strengthening drug I've been getting instead of Zometa. I told the nurse about my week of symptoms (stupid, fatigue, runny nose and that on-the-edge-of-feeling vertigo), and Dr G came in to talk with me. Between the stupidity (which sometimes gets call "chemo brain") and the not-quite sense of vertigo, he wanted to rule out the possibility of brain metastases and ordered a brain MRI, which I haven't had in a while.
I did a little research and found that vertigo (also called Benign Paroxysmal Positional Vertigo or BPPV), can be related to treatment with gemcitabine, the chemo I just finished. Read here for more information.
So I get an extra week to recover and feel better, I'll have the brain MRI on Friday, and get the results next Tuesday.
I also learned that the Abraxane/Avastin combo is given in this order:
Abraxane on days 1, 8, 15 (of a 21 day cycle)
Avastin on days 1 and 15 (of a 21 day cycle)
I like having more information!
Sunday, May 8, 2011
Trying to enjoy the moment
I woke up Saturday morning feeling great. (I think it had to do with the sleeping pill I took Friday night.) At any rate, I visited a friend in the hospital, went to synagogue, came home and CRASHED with a massive nap. Upon awakening, we ate dinner and then did a small sopping expedition. By the time we came home around 930 PM, I was wobbly on my feet again. By the time we got into bed, I was tired but could not sleep until almost 2 AM.
I guess I should report all these symptoms to the nurses on Monday when I get chemo. Maybe they can tell me if the side effects are related to the chemo combo or tapering off the antidepressants. That's been a week now and I still get the not-quite-vertigo feeling when I move my head too quickly.
I feel more energetic today but still have that creepy sense that the world is spinning even when I am not moving. Rik and I worked in the garden together, me mostly trimming hedges and deadheading the early tulips while he added compost to the raised beds and the strawberries. We have both afternoon and evening plans, a rare occurrence, and I am looking forward to living in the moment and enjoying visits with friends. Chemo planned for tomorrow.
I guess I should report all these symptoms to the nurses on Monday when I get chemo. Maybe they can tell me if the side effects are related to the chemo combo or tapering off the antidepressants. That's been a week now and I still get the not-quite-vertigo feeling when I move my head too quickly.
I feel more energetic today but still have that creepy sense that the world is spinning even when I am not moving. Rik and I worked in the garden together, me mostly trimming hedges and deadheading the early tulips while he added compost to the raised beds and the strawberries. We have both afternoon and evening plans, a rare occurrence, and I am looking forward to living in the moment and enjoying visits with friends. Chemo planned for tomorrow.
Friday, May 6, 2011
Still tired and stupid
I think I may have figured out the tired and stupid feelings. The day before I started the Avastin/Abraxane combo, I also stopped taking my antidepressant. I'd decided to taper down after being on sertraline since last July. It took about six weeks but I finally had the last dose last Saturday. A friend warned me that going from 12.5 mg to 0 mg would be harder than going from 25 mg to 12.5 mg, and boy was she right! So it's possible that my fatigue, insomnia, and feeling stupid is more related to stopping the sertraline than to starting the new chemo combo.
At any rate, having three evening activities in a row this week didn't help either. Somehow I got through everything (still feeling stupid) and plan to do practically nothing today. I will forego yoga so that I don't have to drive while feeling this way. Plus that will allow me to take a nap. I hear the sofa calling now!
At any rate, having three evening activities in a row this week didn't help either. Somehow I got through everything (still feeling stupid) and plan to do practically nothing today. I will forego yoga so that I don't have to drive while feeling this way. Plus that will allow me to take a nap. I hear the sofa calling now!
Wednesday, May 4, 2011
Is this chemo combo making me stupid?
Okay, maybe I've overdone it the past few days. I had evening activities Tuesday and Wednesday (and more on Thursday and Friday). I'm trying to live my life -- stay connected, run errands, meet a friend for lunch. But I feel as though this Abraxane/Avastin combo makes me both stupid and tired, as though I am running at 50% of normal.
Stupidity
At last night's meeting I had some trouble making coherent sentences. My typing has been a little incoherent, so I've had to redo most of my computer interactions. At rehearsal tonight, I had difficulty concentrating on song words, even for the songs I know by heart.
Fatigue
It seems like I am tired all the time. Not necessarily sleepy at bedtime, but constantly run down. Last night I was so tired I stumbled around the house, trying to get ready for bed, but I couldn't fall asleep. (And then I had massive foot cramps every hour, all night long. Okay, maybe lack of sleep is affecting me too.) I hit a wall this afternoon at 3 PM and fell sound asleep on the sofa.
And Monday's was only the first dose of this chemo combo.
Stupidity
At last night's meeting I had some trouble making coherent sentences. My typing has been a little incoherent, so I've had to redo most of my computer interactions. At rehearsal tonight, I had difficulty concentrating on song words, even for the songs I know by heart.
Fatigue
It seems like I am tired all the time. Not necessarily sleepy at bedtime, but constantly run down. Last night I was so tired I stumbled around the house, trying to get ready for bed, but I couldn't fall asleep. (And then I had massive foot cramps every hour, all night long. Okay, maybe lack of sleep is affecting me too.) I hit a wall this afternoon at 3 PM and fell sound asleep on the sofa.
And Monday's was only the first dose of this chemo combo.
Tuesday, May 3, 2011
Abraxane + Avastin
Yesterday was a long day at the Cancer Institute. We arrived at 9 AM and after a short wait, the charge nurse told us that this very day was the first business day Swedish starting using a new consent form. So we walked over to Dr G's office (avoiding most of the pouring rain by going through the hospital walkway).
Dr G explained about the new form, we both signed it, and then he showed me the Swedish Ca Inst's usual protocol for Abraxane , which included Avastin. I'd never had Avastin, and although there has been recent speculation about its effectiveness against metastatic breast cancer, Dr G wanted me to try it. We trudged back to the Ca Inst, signed form in hand.
About Avastin: because it was studied with other chemos and never on its own, the side effects are those related to chemo (generalized weakness, pain, abdominal pain, nausea & vomiting, poor appetite, constipation, upper respiratory infection, low white blood cell count, kidney problems, bleeding problems), diarrhea, hair loss, mouth sores, headache). We'll see which ones I may get.
Because of the last minute change to include Avastin, I had to have some additional tests to check my creatinine level via blood work, take a urine sample as well. I passed all the tests, but meanwhile had to wait for the results. Then it turns out that when these two drugs were studied together, the Avastin was always given first. Since I gave the urine sample more than an hour after the blood, more waiting. We had a friend to visit with, so it wasn't so bad, but still... Dr G did not choose one of the boxes on the Avastin quantity, so the nurse had to make another call to him to determine the dose.
At 1215 PM, Rik and J went to get us some lunch. I had just taken my first bite of Mediterranean Kitchen's farmer's wings (the BEST!) when the nurses showed up to start the Avastin. I had a 4 mg dose of the steroid Decadron as a premedication. The Avastin was given this first time over 90 minutes. It finished around 230 PM with no poor side effects. Our friend J said goodbye after spending a chatty and very garlicky three hours with us.
Next I asked about the IV Zofran anti-nausea med, which it turns out Dr G had not ordered, so the nurse had to call him again. I got the Zofran, had to wait another 20 minutes for it to provide protection, and finally got the Abraxane. Thirty minutes later, we were able to leave. All in all, I spent almost 8 hours in that chemo chair and had a backache you would not believe. Thank goodness we had my iPhone and Swedish's WIFI as well as books and company!
On the way home I simply had to have ice cream, so a quick stop at Molly Moon for some ginger ice cream with hot fudge put me in a better mood. We came home, I quickly fed the dog, checked email, got into my pajamas and was asleep by 6 PM. Rik walked the dog and stayed up a while longer, but he too was asleep by 930 PM.
I woke up today feeling more energetic, with no ache in my ribs at all, even after some hard sneezes. Now it's time to walk Bob and get on with my day. I've already showered, eaten breakfast, re-ordered new prescriptions, checked email, and blogged here. More news later.
Dr G explained about the new form, we both signed it, and then he showed me the Swedish Ca Inst's usual protocol for Abraxane , which included Avastin. I'd never had Avastin, and although there has been recent speculation about its effectiveness against metastatic breast cancer, Dr G wanted me to try it. We trudged back to the Ca Inst, signed form in hand.
About Avastin: because it was studied with other chemos and never on its own, the side effects are those related to chemo (generalized weakness, pain, abdominal pain, nausea & vomiting, poor appetite, constipation, upper respiratory infection, low white blood cell count, kidney problems, bleeding problems), diarrhea, hair loss, mouth sores, headache). We'll see which ones I may get.
Because of the last minute change to include Avastin, I had to have some additional tests to check my creatinine level via blood work, take a urine sample as well. I passed all the tests, but meanwhile had to wait for the results. Then it turns out that when these two drugs were studied together, the Avastin was always given first. Since I gave the urine sample more than an hour after the blood, more waiting. We had a friend to visit with, so it wasn't so bad, but still... Dr G did not choose one of the boxes on the Avastin quantity, so the nurse had to make another call to him to determine the dose.
At 1215 PM, Rik and J went to get us some lunch. I had just taken my first bite of Mediterranean Kitchen's farmer's wings (the BEST!) when the nurses showed up to start the Avastin. I had a 4 mg dose of the steroid Decadron as a premedication. The Avastin was given this first time over 90 minutes. It finished around 230 PM with no poor side effects. Our friend J said goodbye after spending a chatty and very garlicky three hours with us.
Next I asked about the IV Zofran anti-nausea med, which it turns out Dr G had not ordered, so the nurse had to call him again. I got the Zofran, had to wait another 20 minutes for it to provide protection, and finally got the Abraxane. Thirty minutes later, we were able to leave. All in all, I spent almost 8 hours in that chemo chair and had a backache you would not believe. Thank goodness we had my iPhone and Swedish's WIFI as well as books and company!
On the way home I simply had to have ice cream, so a quick stop at Molly Moon for some ginger ice cream with hot fudge put me in a better mood. We came home, I quickly fed the dog, checked email, got into my pajamas and was asleep by 6 PM. Rik walked the dog and stayed up a while longer, but he too was asleep by 930 PM.
I woke up today feeling more energetic, with no ache in my ribs at all, even after some hard sneezes. Now it's time to walk Bob and get on with my day. I've already showered, eaten breakfast, re-ordered new prescriptions, checked email, and blogged here. More news later.
Monday, April 25, 2011
Chronic insomnia
This not-sleeping business is for the birds. I get into bed around 11:30 PM and invariably fall asleep around 2:30 AM. How do I know this? It's the last time I look at the clock until 5:30 or 6 when Rik and Bobka the dog get up. Then I wake up again once an hour, every hour, until I give up and get out of bed around 9 AM.
Is it due to chemo? I have no answer for this one, but I haven't had treatment since April 11.
Is it due to tapering off the sertaline (anti-depressant)? I've only got a week more until I am off it completely, so we'll see what happens next week.
Is it due to not enough exercise? Even when I take the dog on a really long walk for 20 blocks, I still have trouble falling asleep at night.
Is it due to napping in the afternoon? Well, this is a no-brainer. But if I don't sleep at night, and I'm tired during the day plus fatigued from chemo, a nap seems inevitable.
Just grousing here -- I don't really want advice. But I am tired of being tired.
Is it due to chemo? I have no answer for this one, but I haven't had treatment since April 11.
Is it due to tapering off the sertaline (anti-depressant)? I've only got a week more until I am off it completely, so we'll see what happens next week.
Is it due to not enough exercise? Even when I take the dog on a really long walk for 20 blocks, I still have trouble falling asleep at night.
Is it due to napping in the afternoon? Well, this is a no-brainer. But if I don't sleep at night, and I'm tired during the day plus fatigued from chemo, a nap seems inevitable.
Just grousing here -- I don't really want advice. But I am tired of being tired.
Thursday, April 14, 2011
To cut or not to cut?
My post-chemo, newly curly hair had grown in clumps, making me feel a little bit like Bozo the Clown. I was faced with one of the most challenging post-chemo questions a woman can ask: Should I have my hair cut or not?
You see, women don't usually expect to go bald at any point in their lives. Okay, maybe some changes in texture due to biochemistry associated with pregnancy or menopause, but bald? That's for men.
So when I lost my hair to chemo, it was a shock in more ways than one. Not only did I not look like myself to myself, I actually looked like my father even more than in the past. (He started balding young, and I've always had his high forehead.)
Watching my hair grow back from practically nothing over the past few months has been a good reminder that even chemotherapy leaves the body eventually. I began to look more like myself to myself, albeit myself with the kind of 'do I used to pay money for. I still didn't have bangs, so my high forehead was clearly visible. My new curls gave hope to other women in my support group who lost their hair to chemo.
But lately even these new curls felt out of control, so today I took the leap and decided to have my hair cut. The new cut is a tad shorter than I wanted, but more even all the way around, and closer to the shape of my head. And since hair does grow back eventually, when it does, it will grow evenly and not in clumps.
You see, women don't usually expect to go bald at any point in their lives. Okay, maybe some changes in texture due to biochemistry associated with pregnancy or menopause, but bald? That's for men.
So when I lost my hair to chemo, it was a shock in more ways than one. Not only did I not look like myself to myself, I actually looked like my father even more than in the past. (He started balding young, and I've always had his high forehead.)
Watching my hair grow back from practically nothing over the past few months has been a good reminder that even chemotherapy leaves the body eventually. I began to look more like myself to myself, albeit myself with the kind of 'do I used to pay money for. I still didn't have bangs, so my high forehead was clearly visible. My new curls gave hope to other women in my support group who lost their hair to chemo.
Tuesday, April 12, 2011
Gemzar dose #5
Yesterday I had my fifth dose of Gemzar (the first one of the third round). Although everything was slow to get started, I had a hot mocha in my thermos, cold seltzer in a can, a good book (American Rose, the new biography of Gypsy Rose Lee), the daily crossword puzzle and a couple of new apps to play with on my iPhone. My hematocrit was a little bit down, but it's been lower and Dr G has still decided I should get treatment.
I ran an errand and picked up ground sumac at the new Penzey's Spices store downtown, then came home, spoke to my Mom and my Mum and took a three hour nap on the sofa. Made some chicken soup for dinner, enriched with leftover meatballs and vegetables, a beaten egg and lemon juice (sort of a poor man's avgolemono soup, not nearly as good as at the Continental). You can find a recipe here.
In the evening I ran a small fever of 99.7 degrees, but a Vicodin brought my temperature down. At 4 AM I awoke with another fever. Luckily I keep meds bedside as well as a glass of water. I sleepily reached out and took another Vicodin, which soon addressed the headache, achy back, night sweat and other fever symptoms. Of course, at that point I realized I had to use the bathroom, so I took my temperature and saw that the fever was only 99.3 degrees. (I am supposed to call the oncologist if a fever hits 100.5 degrees but decided it was the better part of valor to take the Vicodin and not wake anyone else at 4 AM.)
Eventually I fell back asleep around 6 and stayed in bed until just after nine o'clock. I plan to take things easy today. If the runny nose continues and the fever climbs to that magic number, I promise I will call the doctor's office.
I ran an errand and picked up ground sumac at the new Penzey's Spices store downtown, then came home, spoke to my Mom and my Mum and took a three hour nap on the sofa. Made some chicken soup for dinner, enriched with leftover meatballs and vegetables, a beaten egg and lemon juice (sort of a poor man's avgolemono soup, not nearly as good as at the Continental). You can find a recipe here.
In the evening I ran a small fever of 99.7 degrees, but a Vicodin brought my temperature down. At 4 AM I awoke with another fever. Luckily I keep meds bedside as well as a glass of water. I sleepily reached out and took another Vicodin, which soon addressed the headache, achy back, night sweat and other fever symptoms. Of course, at that point I realized I had to use the bathroom, so I took my temperature and saw that the fever was only 99.3 degrees. (I am supposed to call the oncologist if a fever hits 100.5 degrees but decided it was the better part of valor to take the Vicodin and not wake anyone else at 4 AM.)
Eventually I fell back asleep around 6 and stayed in bed until just after nine o'clock. I plan to take things easy today. If the runny nose continues and the fever climbs to that magic number, I promise I will call the doctor's office.
Thursday, April 7, 2011
Next steps
I saw Dr G briefly today while getting my monthly shot of Xgeva, the bone strengthener that replaces Zometa. (The nurse wanted him to oversee her giving the shot, and indeed he caught her recapping the needle, evidently a no-no.)
Dr G wants me to have Gemzar next Monday (dose #5). He also wants me to have another MRI of my liver. My recent tumor markers indicated a slight increase from the previous lab, but tumor markers alone have not been conclusive for me in indicating disease progression. The MRI should indicate if the liver mets are larger or more numerous than the last time, and whether or not the Gemzar is effective. I have asked for no chemo on Monday April 18 because of Passover beginning that night (we will have a houseful of people) and I won't have chemo on April 25, since my appointment with Dr G is later that week. Then we will review the MRI results and make a plan.
Meanwhile I'm waiting for a call to schedule both Monday's chemo and the MRI. I guess I'll need a ride to and from that test, since going headfirst into the MRI tube exacerbates any claustrophobia I might have. I do wear an eye mask to prevent me from seeing just how close the top of the tube is to my face. Fresh air blows at all times, plus they give you a panic button to hold in case it gets too intense. Still, I think I will take some lorazepam just in case and let someone else do the driving, whenever the test will take place.
Dr G wants me to have Gemzar next Monday (dose #5). He also wants me to have another MRI of my liver. My recent tumor markers indicated a slight increase from the previous lab, but tumor markers alone have not been conclusive for me in indicating disease progression. The MRI should indicate if the liver mets are larger or more numerous than the last time, and whether or not the Gemzar is effective. I have asked for no chemo on Monday April 18 because of Passover beginning that night (we will have a houseful of people) and I won't have chemo on April 25, since my appointment with Dr G is later that week. Then we will review the MRI results and make a plan.
Meanwhile I'm waiting for a call to schedule both Monday's chemo and the MRI. I guess I'll need a ride to and from that test, since going headfirst into the MRI tube exacerbates any claustrophobia I might have. I do wear an eye mask to prevent me from seeing just how close the top of the tube is to my face. Fresh air blows at all times, plus they give you a panic button to hold in case it gets too intense. Still, I think I will take some lorazepam just in case and let someone else do the driving, whenever the test will take place.
Tuesday, March 29, 2011
The day after
Yesterday's Gemzar chemo resulted in some serious fatigue today and a couple of mouth sores. Luckily the pain in my mouth is kept at bay by vicodin and gargling with salt water helps the sores heal. The fatigue is harder to deal with.
I went back to the Swedish Cancer Institute for a shot of Neulasta today to bring up my white blood cell count. Then I had a meeting at the synagogue. By the time I got home around 2 PM I was hungry and pooped. After a quick bowl of soup, I headed straight to the couch and crashed hard.
I've taken to bringing my cell phone, the home phone, a book and a cup of water with me to the sofa before I crash. This time the book slid off my lap almost before I drew the quilt over my legs. I slept hard for almost three hours. I did wake up a couple of times as I bit down on my tongue and hit a sore spot, but went right back to snoozing.
What this seems to mean is that I have about two - three good hours every day in which to see doctors, attend meetings, deal with email etc. and run whatever household errands need to be done. That's limiting, but I will find a way to make it work.
Now it's back to the sofa....
I went back to the Swedish Cancer Institute for a shot of Neulasta today to bring up my white blood cell count. Then I had a meeting at the synagogue. By the time I got home around 2 PM I was hungry and pooped. After a quick bowl of soup, I headed straight to the couch and crashed hard.
I've taken to bringing my cell phone, the home phone, a book and a cup of water with me to the sofa before I crash. This time the book slid off my lap almost before I drew the quilt over my legs. I slept hard for almost three hours. I did wake up a couple of times as I bit down on my tongue and hit a sore spot, but went right back to snoozing.
What this seems to mean is that I have about two - three good hours every day in which to see doctors, attend meetings, deal with email etc. and run whatever household errands need to be done. That's limiting, but I will find a way to make it work.
Now it's back to the sofa....
what if nothing changes?
Today is a treatment day.
For the first time ever, I will have Herceptin on its own (if you don't count the Demerol and Gravol I get to keep the shakes and fevers at bay).
Some people have almost no side effects with Herceptin. Some feel like they have the flu.
Will the fact that my body has such a strong response to Herceptin mean that I feel more of its side effects?
The break from chemotherapy is meant to help me heal and rebuild - physically and emotionally.
The break from chemo is also a risk.
Monday, March 28, 2011
Gemzar dose 4
I had a busy medical day. First a blood draw; then a visit with my oncologist; last my fourth dose of Gemzar.
My red blood cell counts were good after the transfusion a few weeks ago, so no need for another at this time. I will get Neulasta tomorrow to bring up my white counts.
Dr G is cautiously optimistic: "There are at least some peripheral signs that the gemcitabine and Xgeva are working." That is, the pain in my right knee appears to have gone bye-bye, and the largest of three scalp mets is no longer rounded but flat. I will get my CA 27.29 results tomorrow and if the tumor marker has decreased, that will tell us if the Gemzar is indeed working.
I think I should expect a couple of mouth sores this week, based on my experience with dose two, but hope they will be manageable.
I think I should expect a couple of mouth sores this week, based on my experience with dose two, but hope they will be manageable.
Monday, March 21, 2011
Gemzar #3
Today was my third dose of Gemzar. Everything went smoothly but took longer than anticipated. I had a friend with me the whole time, and we enjoyed a great lunch at Cafe Presse afterwards. We shared the butter lettuce salad with vinaigrette and toasted hazelnuts; I had the white bean soup pureed with cream and drizzled with lemon-basil oil; and we shared the chocolat chaud for dessert. C'etait tout delicieux!
I came home and napped for a couple of hours, and hope to sleep well tonight.
I came home and napped for a couple of hours, and hope to sleep well tonight.
Monday, March 14, 2011
The latest Gemzar side effects
I have been steadily feeling better and better since last week's blood transfusion. However, I did notice some additional side effects from the Gemzar which lead me to think this chemo is not quite as tolerable as I hoped.
RASH: Dr G told me to expect a rash on my shins, which showed up briefly as a few large, red spots which were tender to the touch. I had three on my left shin, two on my right. They looked just like spider bites and went away of their own accord over a couple of days.
MOUTH SORES: I developed one sore on the side of my tongue which went away within 24 hours. Now I have two; one on the side of my tongue, but in the back where I can't see it although I can feel it, and the other on the tip of the underside of my tongue. That one is tiny, white, and also tender. I've been gargling with salt water to prevent any infection. So far these are no worse than annoying, and I haven't needed my Magic Mouthwash (xylocaine viscous solution, Zovirax®(alcohol-free), and Maalox®, or Mylanta®).
FATIGUE: This is the kicker. Even after the blood transfusion, I tire easily. Most afternoons I hit the wall around 1 PM and literally collapse on the sofa. Even if I don't sleep, I can't move for an hour or so. If I do nap in the afternoon, then I have trouble sleeping at night. I am trying to do my errands etc. each day in the morning so that I can be home by lunchtime and crash.
This morning I went to Costco, barely made it through the front door with the groceries, shoveled some food into my mouth while standing in front of the refrigerator, and staggered to the couch. I didn't sleep but zoned out quietly with Bobka the dog for an hour or so, then felt refreshed enough to bake an apple pie for Pi Day -- 3.14. (Get it?)
This is my week off chemo and I hope to recover enough to have treatment again next Monday.
RASH: Dr G told me to expect a rash on my shins, which showed up briefly as a few large, red spots which were tender to the touch. I had three on my left shin, two on my right. They looked just like spider bites and went away of their own accord over a couple of days.
MOUTH SORES: I developed one sore on the side of my tongue which went away within 24 hours. Now I have two; one on the side of my tongue, but in the back where I can't see it although I can feel it, and the other on the tip of the underside of my tongue. That one is tiny, white, and also tender. I've been gargling with salt water to prevent any infection. So far these are no worse than annoying, and I haven't needed my Magic Mouthwash (xylocaine viscous solution, Zovirax®(alcohol-free), and Maalox®, or Mylanta®).
FATIGUE: This is the kicker. Even after the blood transfusion, I tire easily. Most afternoons I hit the wall around 1 PM and literally collapse on the sofa. Even if I don't sleep, I can't move for an hour or so. If I do nap in the afternoon, then I have trouble sleeping at night. I am trying to do my errands etc. each day in the morning so that I can be home by lunchtime and crash.
This morning I went to Costco, barely made it through the front door with the groceries, shoveled some food into my mouth while standing in front of the refrigerator, and staggered to the couch. I didn't sleep but zoned out quietly with Bobka the dog for an hour or so, then felt refreshed enough to bake an apple pie for Pi Day -- 3.14. (Get it?)
This is my week off chemo and I hope to recover enough to have treatment again next Monday.
Thursday, March 10, 2011
Pleural mesothelioma and its treatment options
Mesothelioma is a critical and fatal cancer. It is caused by direct exposure to asbestos. Mesothelioma cancer is categorized into three categories: pleural mesothelioma, peritoneal mesothelioma and pericardial mesothelioma. This destructive cancer damages the mesothelium which is a membrane that forms the lining of several body cavities like the pleural (thoracal cavity), peritoneum (abdominal cavity) and pericardium (heart sac).
After the diagnosis of pleural mesothelioma you can opt for several mesothelioma treatment options. The factors like the patient’s age and history, location of the tumor, and stage of the cancer are to be noted while treating the patient. The different treatments available for the pleural mesothelioma are radiation, chemotherapy, pneumonectomy, and palliative therapies. Pneumonectomy means removing the cancerous lung or parts of the diaphragm where the disease has spread. In this treatment parts of chest and surrounding tissue which may be affected by the cancerous cells are also removed. This treatment can be carried out depending on the patients overall health, the amount of asbestos inhaled and the spread of the disease.
The next form of treatment is radiation. In this treatment the area affected by the cancer is exposed to the radioactive source. These radiations destroy the cancerous cells. Radiation therapy do not cause any harm to the healthy cells. Chemotherapy is one of the common treatments for pleural mesothelioma. In this treatment high power drugs are given to the patients either by injecting it or in the forms of pills. These drugs may cause some side effects such as vomiting, hair loss, nausea, weight loss and fatigue. The disadvantage in this treatment is that the drugs administered have to make their way to the cancerous cells, unlike radiation therapy where the radiation is directly targeted to the affected area. This may cause harm to the healthy cells as well.
Palliative therapies involve extracting extra fluid by needle and suction from the affected areas. In order to keep fluid accumulation under control, drugs are used. Researches are being performed to find new ways to treat this deadly cancer and so you should always keep yourself updated with these treatments and researches.
Pleural mesothelioma
Pleural mesothelioma is one of the most common forms of mesothelioma. More than 75% of victims fall in this category. This cancer affects the outer lining of the lungs and the chest cavity and makes it thicket. Symptoms of pleural mesothelioma are very common like difficulty in breathing, pain in the chest, fatigue, swelling of the face and neck, trouble when swallowing, cough and weight loss. These symptoms are shown by other diseases also and hence it becomes difficult to diagnose this cancer. Lining of the lungs are made up of two layers, parietal which covers the chest wall and visceral which covers the lungs. Mesothelium cells grow and produce a tumor which enlarges the space, causing it to fill with fluid. This extra thickness in layers is known as pleural effusion which leads to discomfort and pain in the chest. The pain may also be felt in the arms and the shoulders.After the diagnosis of pleural mesothelioma you can opt for several mesothelioma treatment options. The factors like the patient’s age and history, location of the tumor, and stage of the cancer are to be noted while treating the patient. The different treatments available for the pleural mesothelioma are radiation, chemotherapy, pneumonectomy, and palliative therapies. Pneumonectomy means removing the cancerous lung or parts of the diaphragm where the disease has spread. In this treatment parts of chest and surrounding tissue which may be affected by the cancerous cells are also removed. This treatment can be carried out depending on the patients overall health, the amount of asbestos inhaled and the spread of the disease.
The next form of treatment is radiation. In this treatment the area affected by the cancer is exposed to the radioactive source. These radiations destroy the cancerous cells. Radiation therapy do not cause any harm to the healthy cells. Chemotherapy is one of the common treatments for pleural mesothelioma. In this treatment high power drugs are given to the patients either by injecting it or in the forms of pills. These drugs may cause some side effects such as vomiting, hair loss, nausea, weight loss and fatigue. The disadvantage in this treatment is that the drugs administered have to make their way to the cancerous cells, unlike radiation therapy where the radiation is directly targeted to the affected area. This may cause harm to the healthy cells as well.
Palliative therapies involve extracting extra fluid by needle and suction from the affected areas. In order to keep fluid accumulation under control, drugs are used. Researches are being performed to find new ways to treat this deadly cancer and so you should always keep yourself updated with these treatments and researches.
Transfusion marathon
Yesterday was so LONG.....
I left the house at 10:45 AM for my 11:00 appointment at the Swedish Cancer Institute for a blood transfusion. Just a few blocks from home I realized that something didn't sound right with the car. Sure enough, the front left tire was completely flat. Thank God for cell phones. I called the Cancer Institute to explain I'd be late; called AAA for emergency road service; called my friend G, who was going to hang out with me during the transfusion.
The emergency road service truck arrived in only 20 minutes, barely enough time for me to decide what music to listen to while waiting (I chose Hedwig and The Angry Inch, which is completely fantastic). The technician changed the tire for me and put on the small spare. I drove off to the nearby Les Schwab Tire Center, where they were able to patch my flat tire right away. So I was only an hour late to my transfusion appointment.
By the time I arrived at noon, the Cancer Institute the waiting room was completely full. G met me around 1 PM. Just before she arrived, the charge nurse told me there was a delay in getting the blood and that it wouldn't arrive until 2 PM. G had brought lunch, so we sat in the waiting room enjoying lamb sandwiches from Mediterranean Kitchen. Just as we started a Scrabble game, the nurse called us back to the treatment area.
By 2:30 I was hooked up and getting the first unit of blood. G and I played Scrabble until she had to leave at 3 PM. I finished my book, Sue Fishkoff's Kosher Nation. I leafed through magazines. I played on my iPhone, listened to music, talked on the phone. (Thank God for that toy!) Man, was I bored out of my gourd.
Around 5 PM they switched to the second unit of blood. It turns out that blood units are not standardized by weight or volume, but reflect the amount each donor gives. There is a minimum amount required, but each unit can vary widely from others. So my first unit was about 220 ml, which went in over about two hours, but the second unit was more than 450 ml, and it took almost three hours to transfuse. Plus waiting for it to arrive.
Of course I hadn't planned this would take so long. The hospital cafeteria would have brought me a meal, but they only take cash and I didn't have any on hand. Instead the nurses offered me a sack lunch which had been delivered to the Cancer Institute in the morning. One dry turkey sandwich later, my transfusion ended. I finally left the Cancer Institute at 8:20 PM and was soon walking in our front door.
My back ached from sitting in the chemo chair for eight hours; I had a headache; I was cranky from being so bored for the entire day. But I got a good night's sleep, felt perky enough this morning to walk the dog for 30 minutes, and hope to continue to reap the benefits of the marathon transfusion.
No chemo next Monday!
I left the house at 10:45 AM for my 11:00 appointment at the Swedish Cancer Institute for a blood transfusion. Just a few blocks from home I realized that something didn't sound right with the car. Sure enough, the front left tire was completely flat. Thank God for cell phones. I called the Cancer Institute to explain I'd be late; called AAA for emergency road service; called my friend G, who was going to hang out with me during the transfusion.
The emergency road service truck arrived in only 20 minutes, barely enough time for me to decide what music to listen to while waiting (I chose Hedwig and The Angry Inch, which is completely fantastic). The technician changed the tire for me and put on the small spare. I drove off to the nearby Les Schwab Tire Center, where they were able to patch my flat tire right away. So I was only an hour late to my transfusion appointment.
By the time I arrived at noon, the Cancer Institute the waiting room was completely full. G met me around 1 PM. Just before she arrived, the charge nurse told me there was a delay in getting the blood and that it wouldn't arrive until 2 PM. G had brought lunch, so we sat in the waiting room enjoying lamb sandwiches from Mediterranean Kitchen. Just as we started a Scrabble game, the nurse called us back to the treatment area.
By 2:30 I was hooked up and getting the first unit of blood. G and I played Scrabble until she had to leave at 3 PM. I finished my book, Sue Fishkoff's Kosher Nation. I leafed through magazines. I played on my iPhone, listened to music, talked on the phone. (Thank God for that toy!) Man, was I bored out of my gourd.
Around 5 PM they switched to the second unit of blood. It turns out that blood units are not standardized by weight or volume, but reflect the amount each donor gives. There is a minimum amount required, but each unit can vary widely from others. So my first unit was about 220 ml, which went in over about two hours, but the second unit was more than 450 ml, and it took almost three hours to transfuse. Plus waiting for it to arrive.
Of course I hadn't planned this would take so long. The hospital cafeteria would have brought me a meal, but they only take cash and I didn't have any on hand. Instead the nurses offered me a sack lunch which had been delivered to the Cancer Institute in the morning. One dry turkey sandwich later, my transfusion ended. I finally left the Cancer Institute at 8:20 PM and was soon walking in our front door.
My back ached from sitting in the chemo chair for eight hours; I had a headache; I was cranky from being so bored for the entire day. But I got a good night's sleep, felt perky enough this morning to walk the dog for 30 minutes, and hope to continue to reap the benefits of the marathon transfusion.
No chemo next Monday!
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