My Second Treatment

The second of twelve chemotherapy sessions was scheduled for Thursday. Wedensday night I did a relaxation exercise at a friend's house. We also talked about identifying stressors in our lives and stopping to take a deep breath when we notice them. Then we went to a Qijong class. It was my first time and I found it interesting.

According to Wikipedia, Qigong or chi kung is an aspect of traditional Chinese medecine involving the coordination of different breathing patterns with various physical postures and motions of the body. Qigong is mostly taught for health maintenance purposes, but there are also some who teach it as a therapeutic intervention.

This morning, I had to get my blood drawn at 8:30. At 9:30 I met with my doctors and we discussed my blood counts. I then started my infusion at 11:00 and was out before 2:00.

My blood counts were down again for the second time in two weeks.

Here are the numbers.





The doctors pointed out that my Absolute Neutrophils were very low. They said that we could continue with treatment even if they were much lower but I had to be careful of infections. I was told to call the doctor immediately if I got a temperature over 100.5 degrees.

The infustion itself went well. I had a new nurse because my the nurse I had last week was taking care of one of her sick children. I know one of her little munchkins was sick when I got my first infusion. The nurse that took care of me today was very nice. I'm starting to wonder if Mass General has only great staff.

I started with some pills. They were Andonsetron and a steroid called Decadron for nauseu prevention. It took two trys to get a good vein but once we had one it was smooth sailing. I started with fluids for a short while and then I went on to the Adriamycin (Doxorubicin) I got 46 mg. from 12:19 to 12:33. Next was 18 units of Bleomycin from 12:34 to 12:39. Then we went on to 11 mg of Vinblastine from 12:40 to 12:45. Finally, I got 690 mg of Dacarbazine from 12:50 to 1:50. One of the drugs made my arm itch and feel cool to the touch. The nurse gave me a heat pack that took the chill out of my arm.

I went home and took a nap. Again I've felt no nausea ( as of 1:10 AM) and I ate normally and put up the Christmas tree with my Dad. I'm taking Senna to avoid constipation.

I have a pulmonary function test scheduled for just after New Years. They keep an eye on my lungs to make sure the chemotherapy is not causing any damage.

My mood is a 10 on a scale of 1 - 10.

Follow Up Appoinment One Week After 1st Infusion

My follow-up appoinment was scheduled for today. I had blood drawn and met with my doctors. As has become the custom, I got weighed and my temperature and blood pressure were taken. Then my doctors and I discussed my blood work and my experience with the first infusion. They were happy to hear that I experienced no nausea and said that my first experience was a good indicator of how future treatments would go. I was told that fatigue was the one symptom that might build up over the course of the treatments but even that was usually temporary.

I was told that my blood work was strong but I noticed drops in categories across the board.

One symptom I have experienced is constipation. When you're used to having no problem in this department it's a real drag when you can't go. I'm now taking Senna and Colace and it's starting to get better. I'm definitely going to try to keep on top of this. I'd recommend asking about medication and taking it at the first sign of trouble.

I'd rate my mood as an 8 out of 10.

My First Treatment

I had my first chemotherapy treatment yesterday. It went better than I expected it would and I'm glad I didn't worry too much. The first infusion takes much longer than future infusions. They need to perform a test to make sure you are not allergic to one of the drugs and to teach you what to expect and review information for after you go home. Total time for the first appointment: 7.5 hours. Future appointments should take about 4.5 hours.

Here's how the day went:

I arrived at the hospital at 10:00 AM. My blood was drawn by 10:10.

I met with my oncologist at 11:00. We discussed the fact that my blood counts were good and that I could attend the first treatment. Before every infusion, I'll have to have my blood drawn to determine if I can get the infusion scheduled for that day. The doctor answered all of my questions and we reviewed possible side effects and ways of dealing with them. I was given a consent form to sign.

I read the following about blood counts and chemotherapy on the web:

Low red blood count = fatigue, low energy
Low platelets = bruising and bleeding
Low white blood count = susceptibility to infection

My numbers along with the normal ranges were as follows:
WBC - 7.6 (4.5 - 11.0)
HCT - 41.7 (41.0 - 53.0)
RBC - 4.86 (4.50 - 5.90)
PLT - 278 (10 - 350)
Poly - 56 (40 - 70)

My appointment was over by 11:30 and the infusion was not scheduled until 1:00. I had coffee with my dad and toured a new hotel near the hospital.

At 1:00 my weight, height, temperature, blood pressure were measured. Height and weight are used to calculate the dose of medecine you receive.

By 1:20, I had met my nurse, Pam. She was absolutely wonderful. I feel very comfortable with her and fortunate to have her on my team. She seems very personable and professional at the same time.

Pam inserted the IV into a vein and started administering fluids by 1:40.

From 2:15 until 2:30 I received a test dose of 1 unit of Bleomycin. It is important to determine if the patient is allergic to Bleomycin. I suspect people who are allergic can go into shock. I was told that I shouldn't feel anything when the drug was given to me and that I should say if I felt anything immediately. If so, the nurse would ring a bell and a group of people would come running to help me. After receiving the drug I had to wait an additional 30 minutes to see if I had any reaction.

I was then given two anti-nausea drugs in pill form at 3:05, a steroid called Decadron (Dexamethasone) and Zofran (Ondansetron).

The next set of drugs were given via a push method in which the drugs are injected by the nurse into the IV.

I received 46 mg of Adriamycin from 3:35 - 3:45.

I received 10.9 mg of Vinblastine from 3:46 - 3:53.

I received 683 mg of Dacarbazine from 3:55 - 4:02.

The last one was then given via a drip method.

I received 17 more units of Bleomycin for a total of 18 units from 4:03 - 5:03.

Finally, I got a flu shot in the arm. We discussed what I might expect after going home and when I should call the doctor's office or the hospital if I noticed certain symptoms.

I was given a schedule to use to take the prescription anti-nausea pills I picked up the day before the appointment. The drugs are Zofran, Compazine and Adavan. I was told to take Zofran every eight hours for the first three days. This was non-negotiable. I had to take them even if I felt no nausea. The other drugs could be taken if I needed them in addition to the Zofran.

I booked my appointment for the next session and was done by 5:15 PM.

I felt no side effects at all the first night or the day after. I went to the gym for a three mile walk and ate usually. I was told it was very important to drink lots of fluids. I know that there is the possibility of side effects popping up over the next week or so but I feel great right now and I feel relieved that the process of getting the infusion is not painful or scary. The first time is a little tense because you don't know what to expect but I'm not concerned about going back in two weeks at all.

On a scale of 1 - 10 I would rate my mood at 10.

The Night before the First Treatment

I'm scheduled to receive 6 cycles (12 treatments) of chemotherapy starting tomorrow. The treatments are scheduled two weeks apart for the next six months. Some people receive 4 cycles (8 treatments) of chemotherapy along with radiation. Because the cancerous cells are located in the tissue that was attached to my adenoids, my doctor is trying to avoid giving me radiation. It could permanently dry out my salivary glands. My oncologists seem to be very experienced and I have a lot of confidence in them.

I've learned a lot about the power of positive thought, having a good attitude and prayer over the last couple of weeks. I'm doing my best to focus on the many positive aspects of my situation (such as the share luck of having found this during elective surgery at such an early stage). I'm also very thankful for the support of family, friends, coworkers and healthcare professionals at Melrose-Wakefield Hospital, the Massachusetts Eye & Ear Center and Mass General Hospital.

Now it's time for a good night's sleep to prepare for the coming battle and the path to a healthier me.